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This essay will discuss the origins of social exclusion, explain its meaning and the impact that it can have on groups and individuals in society. It will also describe the significance of social exclusion on people who may experience mental health problems; how government reform has been focusing on raising awareness and also why poverty is very much attached to people who experience social exclusion. It will discuss the greater divide that is being created between the rich and Poor and will also highlight the three discourses and the serious implications and consequences that people who experience these have to live with on a daily basis. It will talk about community care and how the system in which the NHS operates frequently seems to pay little attention to people with disabilities or mental health disorders and how the media should have a large part to play in emphasising the negative attention given to mental health issues.

(Pearson, 2010) Believed that social exclusion often had different meanings to various people and was a controversial subject which usually provoked extensive debate and widespread discussion. There were two different meanings to social exclusion. The first referred to was when an individual isolated and detached themselves from society, the second, how society treated people differently and made decisions that affected the lives of individuals, creating feelings of, powerlessness, injustice and inequality.

Social Exclusion first originated in France during the 1970s. It arose from groups in society being subjected to rejection or being marginalised and cut off from society. It meant that people, who were disabled, in receipt of benefits or those who may have been asylum seekers, frequently lacked any rights or access to any organisations that could represent or support their needs. The Labour government (December 1997) first introduced the (SETF) The Social Exclusion Task force when they realised that there was a significant need to focus on families which were identified as being either excluded, dysfunctional or both.

According to (Jack, 2000) In 1998 a report led by the social exclusion unit revealed that residents who lived in deprived and run down areas often disliked their estates due to the lack of amenities, crime, vandalism, and the fear of violence and drug dealers. (Sheppard, 2006) stated that People who lived in poverty and hardship were socially excluded which caused concern for social workers. However people who struggled to fit in or suffered dispossession were not the only ones excluded from society as other groups within society were marginalised as well.

During 1999 the Labour government set up the National Service Framework (NSF) for mental health in order to improve services for people who suffered with mental health problems. The Seven standards service policy was implemented to promote wellbeing and to eliminate social exclusion. In addition the service wanted to deliver intervention to reduce hospital admissions whilst also being cost effective.

Mental Health has been viewed poorly in the terms of acknowledgement and given less priority and little recognition in relation to policy makers and the general public because of the lack understanding, ignorance and fear. Mental health was deemed as the “Cinderella” service of The National Health Service. This is why the government made the decision to develop the (NSF) (Wilson, et al., 2008)

(Lanyard, 2005) stated that NHS resources were limited. Service users frequently complained of the lack of services, only 8% had ever seen a Psychiatrist and 3% a Psychologist, which was also combined with a long waiting list. People who were depressed often tended to spend little time with their GP and when they did have the courage to see them were usually only offered anti-depressants as a solution. However in comparison a person with other medical needs such as heart problems or cancer sufferers were automatically referred to a specialist.

According to research, the numbers of people now experiencing mental health disorders had grown dramatically in recent years and included people who came from a range of backgrounds and classes.

Christian’s (Pantazis, et al., 2006) pg. 285/286 believed that Policies from central government had identified issues surrounding mental health and taken into consideration the difficulties and adversity in relation to individuals who experienced mental health issues, and on that basis how mental health could suffer and deteriorate as a result of social exclusion. The government had attempted to eradicate exclusion. There was substantial evidence to believe that social exclusion and poverty were characteristics that contributed to mental health problems and it also became abundantly clear that health and poverty were very much related and were difficult and challenging issues to combat. (Gough, et al., 2006, p. 3) Stated that variations of household income and poor health and education did impact on individuals causing communities to breakdown.

(Kirby, et al., 2000) Stated that one of the criticisms of the welfare state was intuitionalism of people who suffered from mental health issues; therefore a framework of community care was developed resulting in care being provided within the home and community setting or separate institutions. The main problems with community care was that there was often little funding and community support, which subsequently resulted in increased suicide rates and homelessness therefore this raised concerns regarding the overall effectiveness of community care.

(Minister, 2004) stated that Research had shown that discrimination and attitudes towards people who suffered from mental health problems still remained poor and inappropriate. Most employers would not employ someone with a mental health problem. People in the community struggled to access resources and in addition were excluded from the law in relation to jury service. (Thornicroft, 2006) stated that over the last 50 years employment statistics showed that people who suffered from mental health problems had declined within the workforce. Employers tended to discriminate against individuals with long term mental health problems especially people who had Schizophrenia. Therefore finding work could be difficult for people who experienced mental health problems.

(Golightley, 2011) Felt that there was little research in the area of groups of people who had profound needs or disabilities, including the deaf, those with special needs or learning disabilities or even those with mental health issues. Mental health services often adopted the preconception that most people who used the service could hear and were White British. It was fundamentally important for professionals not to pigeonhole people and to understand why there may have been changes in behaviour. It was important to remember that challenging behaviour could be linked to the mental health of the individual and not necessarily be due to the disability that they were suffering from.

Young people who were from asylum seeker families and refugees who had suffered trauma and experienced racism felt socially excluded from society. Experience informed us that stress brought on mental disorders; however there was no existing proof that this was the case. Families and children who experienced emotional abuse may have felt isolated resulting in mental health problems.

(Watkins, 2009) Stated that attempts had been made to try and change people’s perception towards mental illness; unfortunately with little effect. Poor views still remained strong towards mental illness with the opinion that people who were mentally ill behaved irrationally and displayed aggressive behaviour. The media was a very negative force and exacerbated stereotypical views. (Cutcliffe, 2001) Also believed the media increased poor representation of mental illness and portrayed people suffering with mental illness as violent and dangerous, therefore promoting stigma and further ostracism from the public. The tabloids helped develop hysteria and could be a very powerful resource that influenced poor perception of mental illness and ignited outrageous high levels of public ignorance. (Anderson, 2003) Stated that views are similar, in that films have been produced and have often used destructive language. For example “Psycho” and the “One Flew over the Cuckoo’s Nest” are both films that have had an impact and lasting effect on individuals and influenced and formed people’s perception of what mental illness was seen to be.

Loneliness and feelings of despair encompassed the lives of the individuals with mental health disorders, even when there was contact with family or friends, the feelings of isolation could still remain. Deeper depression and low self-esteem tended to increase due to a lack of activity and structure within their lives. In the long term this could result in the individual developing feelings of self-worthlessness and forming a poor view of themselves with a feeling that they were not contributing anything to society. This could eventually result in the individual removing themselves from any form of social contact or interaction. (Granerud & Severinsson, 2006)

(Levitas, 2005) discussed the three discourses in relation to social exclusion. In British Politics the main objective was to reveal the three versions of account to social exclusion. RED the redistributionist discourse is primarily related to poverty and lack of materials and access to resources and inequality. The lack of provisions appeared to be the underlying cause, some people would say that through redistribution of wealth and taxation poverty would be eliminated.

(MUD) The Moral Underclass Discourse applied to attitudes towards moral obligations in relation to neighbourhoods and communities and the belief that people who resided in poor neighbourhoods and who were in receipt of low incomes were more likely to experience criminal behaviours or be unemployed. It was very much aimed at gender such as fathers who failed to pay child support and young males who chose crime as part of life or single unmarried mothers. A society that held these values could often believe this behaviour was acceptable.

(Hills, et al., 2002) Stated that both Upper and lower classes were similar in many ways, and had more in common than it may have been thought. People who experienced deprivation and resided in poor “ghetto” areas were more likely to have had little police protection. However, in contrast the wealthy of gated communities would usually have their own security. In addition the poor tended not to vote, whereas the wealthy did not need to as they usually had connections to political parties by funding organisations.

(SID) Social Integration Discourse was emphasised on the labour market and influenced by the Labour Government, it featured some of the RED but felt exclusion came from the labour market.

(Berns, 2007) stated that People who suffered mental disorders experienced poverty and economic pressure which impacted on their self-esteem. Consequently they could struggle to either sustain jobs, or take up training and education because of feelings of hopelessness, therefore making it impossible to alleviate poverty and improve life chances.

Through evidence and research my conclusion is that there is much more to be done for people who experience mental health problems. I have discovered that people’s attitudes, ignorance and biased views towards mental health are formed by opinion rather than understanding. Throughout this essay I have confirmed that social exclusion exists within services and society. The NHS budget on mental health is limited and substantially small in comparison to other medical conditions and as a consequence many medical staff and professionals still carry the preconception that medication is the only answer to the problem. There is little intervention in relation to therapy, counselling or alternative approaches which in turn could be more productive and rewarding. With small amounts of money spent on resources and little effort being put into care and rehabilitation, there is less chance to enhance the lives of the most socially excluded. Equally people with mental health often suffer within the workplace and can experience further prejudice and discrimination, coupled with feelings of guilt and hopelessness for not fully participating in the work force. Sufferers of mental health can also often feel rejected by society and feel ostracised for having what they feel is a mind that is broken. However in comparison to this, physical conditions are frequently met with sympathy, warmth and understanding. The media can be responsible for reinforcing negative public views and in promoting stigma and fear towards mental illness. Leitvats discussed the three discourses and looked at the holistic features that impacted on the socially excluded. I feel all three categories relate to people who are suffering with mental health problems. The government needs to do more to eradicate discrimination and aim to highlight positive attention and awareness to change people’s perception. (Commission, 2012) Stated that to encourage a quality of life and wellbeing and opportunities for people with mental disorders there needs to be radical changes in order to prosper and gain employment and to feel part of the community. To feel included would be the ultimate freedom but what a massive task it will be in order for this to be fulfilled. There is hope however, with new and innovative campaigns being introduced such as “The Time to Change” campaign, which is funded by the (DOH) and which is being supported by many celebrities, such as Gary Lineker and Stephen Fry. This is a positive step forward as many celebrities are now opening up and being prepared to speak out about their own experiences with mental health problems. In the long term this can only benefit society in raising awareness and changing attitudes towards the stigma that mental health carries.

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All activities and behaviours that people have can have different positive or negative impacts on their lives, partially because of potential risks which are easy to predict or manage. According to Leitch (2009) the word risk does not have any physical existence; rather it exists only within the mind, like many other abstract words such as idea, concept, attitude, emotion, and culture.

This essay will firstly discuss the concept of risk and public protection, and how it has developed, with particular attention on the meaning of risk assessment and risk management. Secondly, it will focus on government inquiry and its effects on legislation and policies, as well as the benefits and failures of inter-agencies and inter-disciplinary policies with particular reference to risk and public protection.

The concept of risk can be defined simply as the probability of suffering some damage or injury, catching a disease or in some circumstances even dying. At a more complicated level, it can be defined as the chance or probability of an undesirable event happening with an undesirable result (Duffey & Saull, 2005).

The term risk, like many other concepts, can be used in different ways. The Oxford English Dictionary defines the term risk as, “hazard, danger; exposure to mischance or peril” (Alaszewski et al., 1998 p3).

Risk could be the probability of losing a valued resource. For instance, the risk of investing money could be losing that money; the risk of going rock-climbing might be getting injured or dying. On the other hand, some people take that risk in order to gain positive outcomes such as profit from investing that money and a feeling of adventure or thrill at going rock-climbing (Neill, 2003).

Duffey and Saull (2005) explain that risk is the chance or likelihood of a disaster occurring, and its potential cost, during a specific period of time or under specific circumstances. Giddens (1994) argued that the nature of risk has resulted in a crisis in the welfare systems of contemporary society. However, he had suggested that using it can lead to a rethinking of welfare.

Duffey & Saull (2005) argue that risks regarding health are defined in terms of the probability that an individual will suffer from disease or injury within a given time period. In fact, there are various sources of risk. For instance, some risks could be environmental, such as those caused by natural disasters, poverty and war. Furthermore, community, family, school, and friends are all causes of environmental risk, while some risks are due to personal lifestyle, such as smoking, lack of exercise, un-balanced diet and so forth.

According to Alaszeweski et al. (1998) in the seventeenth century the word ‘risk’ seems to have appeared in the English language derived from the French risque, that had in turn come from the Italian ‘risco’ which means to run into danger. When the word risk came into the English language, it indicated both chance and consequences.

Most people classify the components of risk as follows; occurrence of something bad, the chance of such an occurrence, and the consequences of occurrence. These components could be used to evaluate risk (Merna &Faisal. 2005).

Martin (2002) identifies different sources of risk. For instance,

Physical- damage to individuals, equipment, and buildings, as a result of accidents or natural disasters.

Labour- people unable to do their job because of health problems, career changes, or work pressure.

Political/ social: policy change, protests from community, patients, or service users.

As it is difficult to admit a mistake, whether personal or professional, most people tend to shift the blame and allocate responsibility to others such as the state, agencies, and officials when things go wrong. Therefore, the concept of blame can be defined as follows; “blame is the process of allocating responsibility and punishments when accidents occur” (Alaszewski et al, 1998 p13).

According to the report of a Thematic Inspection, (1995, p12) a risk assessment can be defined as, “an assessment carried out to establish whether the subject is likely to cause serious physical or psychological harm to others”. When the term risk is used, it is generally not thought of as having positive consequences, as most people believe that if there is a risk there is less chance of protection, (Kemshall, 2002). Negative risk is represented by possible events that could harm a plan and which should be avoided. On the other hand, positive risk refers to risks that we initiate ourselves because we see a potential chance of success, along with probable failure.

There are five steps to risk assessments, which are as follows;

Classifying the risk.

Stating who could be harmed and in what way.

Assessing the risks.

Reporting findings and implementing them.

Updating evaluations if necessary (Health & Safety Executive, no date).

Alaszewski et al. (1998) think that risk management is the complete process of identifying, measuring and minimizing the chance of uncertain events affecting resources. Effective assessment and management of risks is a major professional practice in human service professions. It is the main part of any organisation’s strategic management; it is the process of addressing the risks so as to be able to work with the goal of achieving sustained benefits. Effective ‘risk management’ should be able to identify and treat these risks so as to increase the probability of success, and reduce the potential for failure. ‘Risk management’ has to be a continuous and developing process which runs throughout the organisation’s strategy and its implementation.

According to Thematic Inspection by HM Inspectorate of Probation (1995) any effective risk management plan should begin with identifying the potential risks in all its manifestations. Once risk is identified, it must be assessed as to its likelihood of occurence and the extent of any possible damage. After that, all risks should be prioritized so that each can receive the appropriate time and resources. In order to achieve a meaningful and efficient assessment, it must be done thoroughly and accurately and in a timely manner.

Public protection can be defined as the desired result of effective risk assessments and successful risk management (Report of a Thematic inspection, 1995). Due to a lack of safety strategies in organisations and drawbacks in some state policies, the idea of public protection was developed mainly by the public (Becks, 1992). It meant that governments and organisations should play a greater role in ensuring the protection of citizens by evaluating and managing risks.

Currently, there are many agencies that attempt to produce policies and practices in order to address the issue of risk and public protection for vulnerable people like the elderly, children, people with mental health problems and people with learning disabilities. However, there is the problem of how to implement these policies as there is little practical guidance and training (Kemshall & Pritchard, 1996).

In fact, there are many kinds of risk, including the risk of specific diseases, accidents, assault, drug abuse, child abuse, adult abuse, heart disease, cancers, disasters, and poverty. As child abuse is a highly controversial issue and a contested area in contemporary society, this essay will now focus on conceptions of child abuse with reference to a government report on the subject and its impacts on legislation and policy.

Child abuse or neglect may happen intentionally or as a result of negligence towards a child by an adult. According to the report ‘Childhood Matters’, child abuse contains several things which can be harmful to children or which can damage their ability to have a healthy development either directly or indirectly (Hobart & Frankel, 2005).

Despite the international consensus regarding children, that they should be treated with respect and must be protected from any kind of abusive exploitation, there is still a lack of clarity about what exactly constitutes abuse, (Cloke & Davies, 1995).

There are four kinds or categories of child abuse: physical abuse, sexual abuse, emotional abuse and neglect, which are explained below;

Physical abuse is the type which has been most studied. It is defined as: “any non-accidental physical injury to the child” (Child Welfare Information Gateway, 2009 p1). It is a feeling of pain or injury to the body or even a feeling of intimidation (Suryanarayana et al, 2010). Physical abuse’ may involve hitting, shaking, throwing, poisoning, burning, scalding, drowning, suffocating, or otherwise causing physical harm to a child’ (Polney, 2001 p129).

The explanation of sexual abuse is forcing children or adolescents to take part in sexual activities, regardless of their awareness (ibid). Using pornographic material such as pictures or videos of children or encouraging children to behave in sexually inappropriate ways are regarded as non-contact forms of sexual abuse, (Hobart & Frankel, 2005).

Emotional abuse is considered as ‘the most elusive and damaging form of abuse in childhood’ (Terreros, 2006 p1). Psychological or emotional abuse includes a child or young person being continually frightened, rejected or berated. There are a number of adverse effects of this type of child abuse. For instance, a child who is brought up in a home where there is no love or warmth will find it difficult to respond to other people’s emotional needs, (Hobart & Frankel, 2005).

Neglect is when a child’s basic physical and psychological needs are not met. Types of neglect include failure to provide adequate food, shelter, clothing or hygiene. In addition to health care neglect, there is also educational neglect and other physical, emotional, and environmental types of neglect, (Polney, 2001).

Over the last three decades a number of children tragically died as a result of abuse and resulted in the emergence of a number legislations and many reforms in agencies and policies. For instance, the death of Victoria Climbie was one of the most major news stories in the UK and all over the world, and has led to the revision of newer policies to protect children from any aspects of abuse. According to a public inquiry there were at least twelve chances for either social services or the police to save Victoria’s life, (Hobart & Frankel, 2005).

Adjo Victoria Climbie was born near Abidjan on the Ivory Coast in West Africa, and died in the intensive care unit of St Mary’s Hospital in London in February 2000 after suffering months of multiple injuries as a result of abuse and neglect from her aunt, Marie Therese Kouao and the aunt’s partner, Carl Manning. Both of them are now serving life sentences in prison (Laming, 2003). According to her parents, Victoria was the fifth of seven children, and she had a good life with them. She was also good at school. The tragic story of Victoria started when her aunt Marie took her from her parents to travel to France, where she had been living for some time, in order to give her a better life and good education. However, they only stayed there for about five months. Victoria began to appear unwell at school and the school was concerned as to whether this was the result of child abuse. Kouao told the school that she wanted to remove Victoria from the school and travel to London in order to get her the necessary treatment. They travelled to London in April 1999, (The Victoria Climbie Inquiry Report, 2003).

The year 1999 was a year of suffering for Victoria, especially once she moved in with Manning, her aunt’s partner. Before that Victoria had spent much of her time with a childminder, Priscilla Cameron, while her aunt was at work. Mrs Cameron noticed the way in which Kouao treated Victoria. When Kouao met Manning she and Victoria moved into his flat, and it was at this time the abuse of Victoria started. Mrs Cameron noticed that the bruises and marks on Victoria’s body and face become worse during the period she was living with Manning. On 13 July, 1999, Victoria was kept overnight in Mrs Cameron’s house because Manning did not want her living with them. The next day Mrs Cameron’s daughter took Victoria to the Central Middlesex Hospital, as she suspected the injuries were not accidental. After the examination the doctor performed, he referred her to the paediatric registrar, and although Victoria was admitted to the hospital and Brent social services and the police were informed, none of these agencies intervened to protect her (Laming, 2003). During his trial, Manning said that Kouao would hit Victoria every day using different items such as a coat hanger, a shoe, a cooking spoon and even a hammer. In addition to this, Manning admitted that he would hit Victoria with a bicycle chain. According to the Victoria Climbie Inquiry Report, (2003) Victoria was treated like an animal, barely fed and forced to sleep in the bath in an unheated bathroom. As a result, her death was due to all kinds of abuse, (physical, emotional abuse and furthermore neglect).

The outcry about Victoria’s death led to the Laming Report, which was published in 2003 by the government to investigate the involvement of the various agencies in the case and to make recommendations for change in order to avoid such a death in the future. Moreover, this case led to the reshaping of services for children and the reform of child protection agencies in England and Wales, (Hobart & Frankel, 2005).

The Laming report discovered the circumstances surrounding Victoria’s death, and it indicated the failure of the social, health and police services in safeguarding her. Furthermore, it attempted to address the concept that some of the professionals in Victoria’s case might have been obstructed by accusations of racism if they had followed a particular action. Thus, the Laming Report suggested that, ‘child safety comes first,’ meaning child protection is the entitlement of every child regardless of his or her cultural heritage or background (Garrett, 2009).

There are other cases of children who died as a result of cruel abuse, such as Marria Colwell in 1973, Susan Auckland in 1974, Tyra Henry in 1984, Chelsea Brown in 1999 and many other cases whether known or unknown. While the circumstances of each case might be different there are points of similarity, especially when the following features which occur more than once are taken into account;

There is no communication between people and agencies.

Inexperienced social workers who lack necessary skills.

Lack of resources to meet demands (The Victoria Climbie Inquiry Report, 2003).

Every Child Matters was published in September 2003 and issued some recommendations to be implemented in 2004. These included;

The job of the Children’s Commissioner is to raise awareness of the interests of children and adolescents.

The duty of local authorities is encouraging cooperation between agencies.

Legislation for the setting up of databases so that children’s basic information will be there to help professionals in providing support to young people.

A director of children’s services and a lead member will be appointed by local authorities in order to be responsible for education and social services with regards to children

The production of a single children and young people’s plan would be demanded of local authorities, (Hobart & Frankel, 2005).

The focus of the Children Act 2004 was on encouraging partnership and collaboration between health, welfare and criminal justice agencies, as well as raising their awareness of responsibility (Stafford et al, 2010).

According to Foley et al (2002) the child protection system in the UK for dealing with child abuse and neglect has not been effective enough at dealing with the problems of a large majority of families and their children. The development of such a system can be traced back to a number of high profile child abuse cases and has been dominated by a preoccupation with surveillance and investigation. The major concern of such a system was with only a small number of the total incidences of neglect and abuse; a total which is expected to rise every year. Such a system was also not successful in providing the necessary services which are essential for meeting the needs of most of the families and the children who were investigated.

However, over many years the fundamental aim of policies has become to push different agencies and professionals to work together where there are concerns about child protection, or safeguarding and promoting the well-being of children. This was promoted and strengthened in 2006, by the establishment of Local Safeguarding Children’s Boards (LSCBs) for improving safeguarding practices, polices, training and quality control in every local authority area. They identify accountability and compile information for Serious Case Reviews, where a child has died unexpectedly or been seriously injured and abuse is obvious or suspected to be a factor (Stafford, 2010).

Interagency means two or more agencies working together in an official way in order to achieve an aim or several aims (Fitzegarld et al, 2008). Hence, each agency supports another by giving information, experience and other provisions when they are needed. It can be said that they act as a public body towards definite purposes.

Currently, many agencies such as the police, social services, health services, and other relevant agencies attempt to produce policy documents in order to address the issue of risk, but there is little training or practical guidance with which to apply these policies (Kemshall & Pritchard, 1996).

Inter-agency co-operation, whether for community care or for child protection, is often directed by central government. However in practice this often causes difficulties and so these organisations tend to keep their own independence rather than attempt to co-operate. Hence, agencies are unlikely to change certain roles unless they are persuaded that it is their duty (The Scottish as Government, 2003).

Over the last three decades, the deaths of children in the UK have caused changes to both policy and practice, especially after Victoria Climbie’s death. This case highlighted a failure by child protection services and indicated a lack of effective communication between health professionals and social workers. “The extent of the failure to protect Victoria was lamentable. Tragically, it required nothing more than basic good practice being put into operation. This never happened” (Lord Laming, 2003).

Due to so many children dying because of different types of abuse, it has led many agencies to improve child protection systems. However, because of the shortage of resources and staff, especially in social services’ child protection division, there are still concerns that these improvements and changes will not be enough to protect children. Therefore, it is important to increase the quality of child protection in order to raise social awareness (Kendrick, 2004).

The main weakness regarding protecting a child was often a lack of proper evaluation of the child’s needs and demands. Individual errors, poor investigations and poor communication between agencies are also important factors (Kendrick, 2004).

In fact, before the outcry caused by Victoria’s case, there were many attempts from different agencies to save children’s lives. For instance, in 1986 child line was established by the NSPCC as a confidential help line which children can call when they are unable to get help elsewhere, and in 1999 the UK government published Working Together to Safeguard Children, which focused on setting a national framework for child protection for anyone who wanted to work with children and families. In addition to this, it encouraged the need for protection to be recognised, and for people to take into account the strengths and weaknesses of a family and look more widely at children and families’ needs (Hobart & Frankel, 2005).

As doctors are in an ideal position and are often the first to see and treat serious injuries and trauma they can report abuse allegations to Child Protection Service (CPS) social workers who have a responsibility to protect children. This is especially true considering that victims and offenders will not self-report to the CPS and thus the responsibility for reporting it must fall to others (Vulliamy et al, 2000).

Polney (2001) highlights the crucial role in protecting a child from harm that must be played by health visitors, because they are well placed to assess whether a family’s circumstances may lead to abuse or neglect, and to appreciate whether children are safe or not. As communication and co-operative working is the key, their work must be done in partnership with other agencies and colleagues in order to meet families’ and children’s needs and to safeguard children from harm.

The starting point in providing an integrated service for children and young people was when the UK government published the Every Child Matters (ECM) Green Paper (2003) after the death of Victoria Climbie, and the Children Act 2004 that led to a number of changes in children’s services (Dunhill et al, 2009)

The importance of inter-agency cooperation in the development of children’s services was emphasised by the labour policy. For instance, the National Service Framework for children, young people and maternity services reflects a strategy that demands all agencies work in a way which complement each other in order to address some issues like social exclusion and the children’s fund (ibid).

However, the priority of the new labour policy was to intervene in children’s lives at an earlier stage to avoid and prevent problems that may occur in the future, such as anti-social behaviour, unemployment and crime, before they become chronic problems. Therefore its concern with child abuse was only partial (Stafford et al, 2010).

According to Frost (2005) the way to avoid interference and conflict between inter-agencies is that inter-agency working must be based on formal structures. Moreover, clarity must be one of the aims and objectives of the team members.

There are many elements that are a key to the successful work of a multi-agency, including clear leadership and a clear focus, with common purposes and common knowledge between professionals. This process demands commitment by professionals to regular meetings and to allocating time to learn basic and necessary communication skills (Dunhill et al, 2009).

According to Fitzgerald & Kay (2008) interdisciplinary teams are those who are from various disciplines and backgrounds with different qualifications, experiences and training that play a significant role in making decisions and minimizing risks.

The framework for interdisciplinary training introduced by the Green Paper as a part of its proposals on ‘workforce reform’ had the following key elements:

“Understanding the developmental nature of childhood

Parents and family life

Managing transitions

Understanding child protection

Understanding risk and protective factors

Listening to and involving children and young people” (Williams, 2004 p422).

Parents and carers, early intervention, local and national integration, and workforce are the main four areas of action covered by the Green Paper (ibid).

‘Working Together’ indicates that inter-agency policy is an initiative to address the needs and demands of the most vulnerable individuals in society. The assumption is that improving co-ordination and co-operation between agencies will lead to better consequences in terms of child welfare. However, the inter-agency cultures and structures must be taken into account (Morrison, 2000).

Paragraph 5.54 of Working Together declares that a strategy discussion between the local authority, children’s social care and other services such as school, health and the police should be present whenever there is a suspicion of a child suffering significant harm. The aim of the strategy discussion is to share information, to plan how the enquiries will be carried out and by whom, to agree what action is needed to protect a child, and also to decide whether any legal action is needed (Beckett, 2007).

However, inter-agency and inter-professional communication face some inherent difficulties in some common areas which are as follows:

}Status differences and different areas of expertise;

Negative stereotypes of other agencies or other professionals;

Focussing on different aspects of the problem~ (ibid, P: 29).

According to Lawrence (2004) active dialogue is needed to be kept between managers and practitioners in order to resolve some problems when they arise. Also, it is vital to interact satisfactorily in the lives of children and their families.

Local authorities, differently to other agencies, have statutory commitments and have their own specific aims. However, in working together to protect children, they need to appreciate that they are not only trying to achieve their own purpose, but they are also making a significant contribution in advising and assisting to protect children (Department of Health, 1991).

Social services departments, health workers, medical practitioners, the police, schools, and voluntary sector and others working in a partnership is, in addition to being a way to monitor and review child protection policies, is also a basic strategy for child protection (ibid).

In conclusion, it can be said that risk is a word that means a probability of suffering harm or damage during life, or even of dying under specific circumstances. There are many sources or factors of risk which threaten individual’s lives, in particular the lives of children. These factors include homelessness, financial pressure, living in a disadvantaged community, parental unemployment, environmental factors and many others which impact on people’s behaviour and their treatments of their children. It is undeniable that children rely on their parents or others who care for them to meet their needs, and it is unfortunately also undeniable that sometimes children are abused or even killed by these same people. This has made the relevant authorities develop many policies and strategies to ensure children live in safety and to protect them from maltreatment, as well as to encourage inter-agencies to work together to promote children’s welfare. According to Blair (2003) our children are everything to us: our hopes, our ambitions, and our future.

The concept of identity is described in numerous different ways such as the I, Me, personality, self and essence. These offer a starting point for us to attempt to understand and explain who and what we are internally and within the external world .There are various theories that have been developed to help us make sense of what contributes to our identity. These theories examine the factors that can build, shape and change our identity, covering aspects such as the structure of society, our interactions with others and past experiences.

Identity could be defined as being directly relevant to associated characteristics of an individual’s character or of a group. Identity can be viewed as a both passive and active form, it can be used to help others define us which is usually not controllable by that individual it can also be relevant to how we as individuals view ourselves.(Macionis and plummer,2008). There are various forms of the self and identity the three main groups most individuals are able to place themselves within .These are the collective self, the individual self and the relational self. The concept of identity in modern western society has shifted as a result of changes in ideology and society. These changes have included industrialisation where subjects act as workers who move around for work and have a identity that is flexible and not rigid within social structure and enlightenment where subjects are able to change their identities and create new choices and choosing new value systems (Michael.A, 2008)

The relationship of identity in the structural sense and the actual power an individual has over their identity has been critically analysed by theorists such as Goffman (1999) and Garfinkel (1984) have placed emphasis on the way individuals can develop and mould identity using language.Mead describes a similar form of interaction where personality, interaction and social structure provide a framework that can then be used for an understanding of identity (Choudry,2010,p11). To examine the various theories that contributes to the study of identity in regards to investigating societies understanding of older people. This will be looked at using the following structure, firstly looking at ways in which ‘age’ forms an identity will be considered. Secondly, the influence of theorists on attempting to understand the process by which this identity is created will be examined. Third, the concept of stigma and its repercussions will be discussed. Finally, the role and identity both personal and professional of the Social Worker as an agent between structural aspects and the impact of this role on the service user.

How old an individual is and how this influences identity varies and can be interpreted differently from different personal perspectives and cultures. From an objective sense age is simply the culmination of a process that is begun at birth and one that is given certain social indicators (Taylor and field, 2007, p.113). Older people or old age in many societies worldwide is not clearly defined but usually a term used when referring to someone a few years older than the individual being referred to (Miller,2008). Various cultural views can produce pressure on who is considered young or as an older person within society. This can vary according to cultural context (Stephens and Leach, 1998,p.475).

The implications of being identified as an older person can cause tension between the potential conflict of the individuals view of their identity and the structural view . In traditional society, the identity of the elderly is often a prescribed element, that presupposes norms of clothing and behaviour (Taylor and field, 2007).Other members that belong to that particular traditional society are projected with ideals of how to behave in a manner suited to people of an older age a manner that would change for another person of similar age (Stepehns and Leach, 1998, p. 476) . These assumptions have the ability to reduce the amount of power a older person has as they are defined and categorised based on visible characteristics rather than as a whole person (Miller,2008). Therefore social workers interpretation of an older person should fully consider the relationship between identity ,older people and structural factors.An older person may not view themselves as simply fitting in to a particular category such as ‘older person’ even if society is able to do so.

There are many different sociological theories that can assist in understanding contemporary societies attitude to identity when referring to older people (Giddens,2000 ,p.521).Within social work acknowledging and utilising the right of self determinism is an important part of the framework created when providing support and assistance to older people(Miller, 008 , P4). When identifying a person in need the role of the social worker could include providing a range of suitable options to choose from. However the social worker would provide the older person with the tools to make an independent decision. This can be explained by the adherence to identification in terms of the agency exerted by the older person (Franzese,2009,p.71).It is important that the social worker refrains from categorising the elderly originating from the perspective of an ‘older person’ but viewing as an independent individual in need (Franeze,2009).To assume without proof about the lack of ability of an older person must be avoided. This can create a tendency to make judgements and disempowered the service user, leading to lack of understanding in regards to the care and support required. Especially in regards the older person’s ability to make independent informed choices based on a understanding of their life and being the ‘expert within their own situations’. Although there are types of illnesses such as mental health issues that tend to occur more in the elderly than in the younger generation the social worker needs to assume the service user is capable -so regardless of how the service user is generally presenting him o herself unless presented with proof that suggests otherwise. Using this method in social work and emphasising the person centred approach can be explained through understanding the right to self determinism and empowerment (Kim, 1991). To practice effectively the social work must actively avoid becoming complacent with the attitudes towards older people projected through dominate discourse in contemporary society. This discourse projects identity on to individuals using age as way of categorising the social work need to provide the individual with the right to self-determination.

This is a difficult perspective to maintain when the structure of society promotes and accepts the idea of defining individuals in regards to age (Giddens,2000).This is also difficult to maintain when surrounded with many resources that are provided to those in need by social services that are allocated based on age and therefore creating restrictions if an individual does not fall into that age bracket. Therefore suggesting it is difficult to completely avoid catergosring older people as this is the system used in the society they exist in. This can be examined by looking at psychosocial identity, although Giddens suggests that we are reflexive agents we may have a smaller agency than what is suggested (Newman and Newman,2008).This suggests the rationale model of decision making for an individual is limited in its uses ; the choices we make are usually created for us to some extent as they are usually made when need or desire ansd the actually outcome only clear after the choice has been made.(Newman and Newman, 2008). Consequently an older person may experience the limitation of making a rational choice in regards to their identity as these choices may be made from a particular need. The older persons rational choices maybe affected by anxieties and fears surrounding their identity. As a result the role of the agent is quite limited in regards to the way interaction occurs between agent and structure. Therefore the individual has less choice than what may be assumed.

Another important element for understanding identity in relation to contemporary social work is the subject of stigmatism. Stigma can be explained as a loss of individual social identity and status that occurs when an individual is simply looked upon as a member of a group with shared characteristics (Giles et al., 1990).The concept of being an older person could be looked upon as a creation of society rather than something that has naturally developed through positive association. This is relevant to older people as stigma can produce problems as it relates a number of conditioned to older people, stereotyping them (Giddens, 2000).Bringing in ethical practice a better way to avoid projecting identity on to an older person it would be more effective to avoid placing stigma upon the older person.With messages provided by the media in various forms such as television advertisements that depict older people as suffering from illness and being in need. When only provided with these images of older people not stigmatising within social work would appear to be problematic. Structural aspects such as bureaucratism and globalisation make community self determinism and professional independence very difficult if not impossible (Bowles et al,2006).There is an conception that older people after being classified as ‘older’ change from being active to passive members of society with limited involvement and are limited in their self-determinism. Goffman proposed a definition of stigma that emphasisies the differences between the virtual self in social identity and the actual social identity.(Goffman, 1969)

Tension that has been identified by Sociological theory therefore is concerned largely with the interaction between the agency of an individual against the stigma that may be imposed upon the concept of the elderly, and their own right to self-identity (Newman and Newman, 2008, p.388). To an extent, as is represented by the psycho-social theoretical standpoint, it is difficult to argue from the perspective of interactionism the ways in which the individual has a significant agency in order to combat this perspective (Macionis and Plummer, 2008, p.76). Garfunkel (1967) argues that language is used as an active means by which individuals shape the identity around them. Rather than accepting a social identity that is imposed by the social structure in which they find themselves, individuals are active participants in the creation of such categories (Stephens and Leach, 1998, p.24). Of course, given that much of the social stigma associated with ageing stems from the ways in which the elderly are portrayed as mentally unstable, passive victims with mobility issues, all of which can be supported with a certain degree of statistical evidence, the ways in which individuals can rail against the stigma is problematic (Newman and Newman, 2008, p.289). However, the stigma is better understood as a blanket type definition applied to all individuals within a certain category ignoring the extent to which they fall into such categories. Identity theories, particularly from an interactionist perspective, are quite limited in their approach to describing how each individual holds their ability to actively define themselves in opposition to such stigma.

The use of identity theories are not only significant for the ways in which Social Workers treat the elderly but can be seen as useful understanding the means by which the individual appreciates their own impact upon the context (Giddens, 2000, p.522). In particular, an understanding of the interaction between agency and structure can help the individual reflect on the extent to which certain roles are almost predefined by the context in which they find themselves (Haslam, 2003, p.99). First, the Social Worker’s role can be interpreted in the way in which they can be seen as part of the social structure. The fact that the provision of services can be interpreted in a negative fashion as the imposition of structure allows the individual to assess their own role and position within this context. Furthermore, the individual must appreciate their own potential for agency within the structure in the attempts provided for the avoidance of oppressive practice (Newman and Newman, 2008, p.388). An important element of this process is in the use of reflective practice which allows the Social Worker to assess their own individual approaches and their emotions to the servo e provision. The extent to which they view the elderly with a stigma, or make assumptions regarding their ability to provide their own active approach to their own identity can be self-assessed. In many cases, it is possible for the Social Worker to adopt the Goffman idea of a distanced role, where they play a role in the service provision that fits various notions of the ideal way that such services can be provided without stigma (Goffman, 1963, p.54). This will involve occluding their true feelings or impressions of an individual, and the reflective practice allows them to assess and understand their approach to the subject (Goffman, 1999, p.16). The notion of the importance of agency within this context is therefore a key way in which Sociological Theories have affected Social Work practice.

A range of effects have a significant effect on the way in which individuals are influenced in their identity (Giddens, 2000, p.522). In many such cases it is almost impossible for the elderly to exert their own level of agency in order to resist the categorisation and the accompanying stigma that often applies. In many cases, this can occur as the result of active influences on the part of the individual themselves, even if it is a distanced social role as suggested by Goffman (1999). The important influence of such theories upon the understanding of identity, however, fall into the area where the Social Worker can be seen as part of an active element of the structuration process (Zastrow, 2009, p.59). This is a difficult role to avoid on account of the fact that despite the ways in which agency is emphasised for the individual for whom care is provided, the provision of services is often defined by age rather than simply by need. From the perspective that to avoid stigma as a whole, it could be expected that the various requirements of the elderly may come under different remits, such as mobility issues coming under the disabled remit; and in many cases this does continue (Zastrow, 2009, p.61). However, the fact that certain benefits are available to the elderly on the basis of age alone means that the Social Worker remains an agent, albeit an active one, of the notion that age defines a social identity. This social identity therefore means that there is a subgroup of services that would be provided, and this perhaps undermines the active attempts to avoid imposing stigma on the concept of the the elderly and allow the individuals to impose their own agency.

The most useful forms of identity theory would appear to ultimately stem from Lemert and Mead, that emphasise the position of an interaction between structure and agency (Franzese, 2009, p.71). As has been described in the previous discussion, elements that emphasise the process of either agency or the role of structure tend to miss the point of the way in which elderly people interact with the definitions that are applied to an identity. For the Social Worker there are numerous advantages that can be gained from an understanding of such theoretical contributions and the influence of different theories can help understand the requirement to avoid stigma and the emphasis that is made in Social Work to the process of individualisation, despite the inherent contradictions that can exist in the way in which services are provided. Social Work is essentially a part of society and represents and reflects the processes within it; as such, Sociological theories will always be of use in explaining and describing the ways in which different processes form a part of practice (Franzese, 2009, p.71).

Introduction

This essay aims to identify and critically appraise evidence of whether ‘social intervention’ improve outcome for depression in British Pakistani women. I will analyse whether ‘social intervention’ can lead to improve mental wellbeing, empowerment and individual growth. I will analyse the value emphasis of therapeutic social support in mental health. The context of social work practice in mental health is complex, therefore social work intervention has to have an ethical and value based framework. I will assess the theoretical basis for standardise practice. The statutory changes in Britain to consider the fundamental values position incorporated in recent policies and legislation will be examined.

Define the concept of evidence based practice

Evidence based practice (EBP) according to Sackett (1997) citied in Gray et al (2009: 119) connotes a process of improving professional judgement through the “conscientious and judicious” integration and synthesis of well-researched empirical evidence to evaluate the efficacy and effectiveness of intervention in enhancing service users’ outcomes and how this can be integrated into practice context to improve service delivery and professional accountability (Department of Health Service and Public Safety, 2012) (Gray, Plath, & Webb, 2009) (Sheppard, 2004) (Corby, 2006). It “gives a framework for analysing the situation and generating a number of possible options” (Thompson N., 2000, p. 35). (Mathews & Crawford, 2011) suggested that practitioners must think critically and reflect on research evidence for credibility, completeness and transferability to inform professional judgement as this an implication for policy makers, professionals, communities and service users.

The impetus for EBP within social work is underpinned on the centrality on service users’ best interest to guide practice that is culturally sensitive and of significance to service users within the dynamic context of practice, legislation and social policy (Bolton, 2002). EBP therefore necessitates social workers’ reflexivity of how values, “theoretical assumptions”, policies, past experiences and the context in which practice takes place combine with service users perspective, preferences, and culture to guide and inform practice (Munro, 2002:10). This is to account for the multifaceted personal, cultural and social dimensions of service users (Webber & Nathan, 2010)

Select an aspect of social work

What interest me in this topic is the gap which exist in providing culturally sensitive support to black and ethnic minority group with depression. The evidence available suggest that individual with mental health distress including depression are “the most marginalised and excluded groups in society” (Stepney & Ford, 2001). Additionally, the prevalence of depression in black and minority ethnic (BME) and in particular women from Pakistani background in Britain, underlines the importance of supporting statutory and voluntary initiatives directed towards meeting their needs (Husain, Creed, & Tomenson, 1997) (Gater, et al., 2009). (Miranda, et al., 2003) noted the gap in evidence based for ‘social intervention’.

Drawing on their practice experiences and appropriate evidence

Within the context of community voluntary mental health services, their diverse types of evidence that informs practice and policy and social workers have an ethical obligation in the choice of theories and model of working.

In my practice, a systems approach is emphasised in understanding the interplay and multiplicity of service users’ context. Psychodynamic approach is concerned with how perceptions of needs, stigma and stereotypical assumptions motivate human behaviour including help seeking, disclosure of sensitive information. Past experiences are seen as central in the problems individual experience and used in understanding the dynamics of the helping relationship.

Social learning theory suggests behaviours are influenced by service users’ socio-cultural context. For example help seeking behaviour is influenced and reinforced by stigma and service delivery

Therefore cognitive- behavioural therapy is emphasised by understanding the role perceptions in help seeking. Therefore through interaction, modelling service users’ perception is influenced.

Conflict theory is invaluable in understanding cultural conflicts, stigma and oppression, power imbalance.

As noted in Saleeby (1996) the strength perspective is intrinsic to social work values of service users’ involvement, and respecting individual as having strengths

The feminist perspective takes into account the role of gender and the historical lack of power experienced by women. Collaborative relationship is emphasised between the social worker and service user through equality and empowerment.

Through empirical observation using randomised controlled trial, Gater, et al (2010) investigated the effective of ‘Social intervention’ for British Pakistani women with depression. It sought to explain the ’cause and effect’, to predict and control reality, and to create unambiguous objective ‘truth’ that can be proven or disproved to inform the effectiveness of intervention and policies implementation.

Qualitative data used to understand individuals “social reality” within their socio- cultural context which questions cultural assumptions, discrimination and oppression and the implication and significance in implementation. This can be used to conceptualise service users’ perspective regarding intervention and polices implications, their needs and perceptions about current polices and interventions.

The problem solving model focuses on understanding service users in their context and working in partnership.

In a cross sectional study, prevalence of depression amongst women of Pakistani origin was twice as high compare to white European women (Gater, et al., 2009).

(Campbell & McLean, 2002) suggested that social capital resources is embedded in within social networks and improve recovery. An alternative explanatory framework for the prevalence of depression in Pakistani women in mental health statistics has been the social constructive perspective. This perspective encompasses help seeking behaviour.

There are some evidenced based interventions that have been proven to help people recovery from depression. The randomized control trial study by (Harris, Brown, & Robinson, Befriending as an intervention for chronic depression among women in an inner city: Randomised control trail, 1999) found that befriending schemes are beneficial in improving recovery.

This is to counter the criticisms of ‘institutional racism’ and cultural assumptions in the delivery of mental health services to black and ethnic minority groups (Gould, 2010). Phillip Rack (1982) cited in (Gould, 2010): 40 proposed a “Culturally attuned approach that used insight”

This intervention is central to social work values of respecting and valuing uniqueness and diversity and recognising and building strengths. Social intervention involves aspects of partnership and include and emphasis on the impact of environmental pressures on individuals and therefore can be invaluable in anti-discriminatory work with service users in “offering empowerment and dealing with structural oppression” (Ahmad B. , 1990, p. 51). He also noted the importance of importance of qualitative research in exploring these issues (Ahmad W. , 1995). This social intervention included specific target groups. It uses an approach that included education and/or direct contact with people who are depressed.

Social intervention provides social workers with a “structural appreciation of the nature of social problems” (Gould, 2010, p. 60)

(Harris, 2010) social support and depression

Reconnection of hope through therapeutic encounter

Psychosocial and cognitive therapies have now been included in clinical practice guidelines. However, there remain considerable problems with black and ethnic minority accessing these services.

Research has shown a consistent relationship between mental illness and indicators of social disadvantages (Fryers, Melzer, & Jenkins, 2003). Thus, development of strategies to support help seeking and treatment is needed.

(Mathews & Crawford, 2011)

(Orme & Shemmings, 2010)

(Smith, 2004)

(Gask, Aseem, Waquas, & Waheed, 2011) qualitative thematic analysis (social isolation) family conflict, social cultural factors, psychosocial factors

Identify what can be learned from the evidence

In Gater,et al (2010) Social intervention for British Pakistani women with depression: randomised controlled trial, Participants’ social functioning and depression were signi¬?cantly improved. Given the prevalence of depression (Gater, et al., 2009) in this group and the under-representation amongst people able to access supportive services, this presents an important development.

In relation to improving participants’ engagement qualitative studies have found the debilitating effect of stigma as a signi¬?cant barrier for accessing support (Livingston & Boyd, 2010) (Mak, Poon, Pun, & Cheung, 2007). Stigma is understood as the interplay of individuals’ social identity and socio-cultural dynamics in which individuals with mental health are discriminated against and socially excluded due to stereotypical assumption (Lam, 2008). This ¬?nding is consistent with the evidence regarding social support interventions in (Harris, A stress-vunerability model of mental health disorder: implications for practice, 2010). However, there is a gap of how stigma associated with mental illness can be reduced.

The study was of high research quality, which indicates a reduced risk of biasness and confounding. A major limitation of this study is heterogeneity amongst the sample, that only 123 participants and increase in social functioning is limited to only 3 months. Therefore, the medium to long-term effects of social intervention within this group remain largely unknown. Another research gap is the absence of a dynamic medication adherence related studies aimed at this group, which have been identi¬?ed as important for achieving adherence and better outcome for depression (Miranda, et al., 2003).

Addressing the resistance from family members around issue of confidentiality and stigma amongst this population may be best accomplished through culturally appropriate communication strategies that facilities warm and empathy and social capital. In contrast, the research suggests that social intervention although it improves depression in the short run will not achieve meaningful improvements in the long run without antidepressant.

(Department of Health, 2007) emphasises partnership working, respect for diversity, strengths and aspirations and service users centred. Its focus on effectiveness, accountability and personal development are congruent with the principles of evidence based practice.

(Slade, 2009) noted that personal recovery is a challenging and contested concept within the domain of empirical evidence. The multi facet level of mental illness is evident in the definition of mental health, the impact of treatment and the social consequences. However, (Resnick, Fontana, Lehman, & RA, 2005) highlighted that “empowerment, hope and optimism, knowledge and life satisfaction” outcome that are central to the recovery model allows the prevalence of recovery to be investigated empirically. (Gould, 2010)

As stated in (Gater, et al., 2009), an epidemiology of depression that accounts for social support and social difficulties is critical. Social context of depression

Nonetheless, depression is associated with important negative consequences, such as social exclusion, low self-esteem.

Social exclusion according to (Hills, LeGrand, & Piachaud, 2004)should be conceptualise in the context of the personal, cultural and structural dimension and highlighted lack of social interaction as a form of social exclusion.

Attuned to cultural beliefs and norms

Social and inclusive practice have been developed and reinforced by the Capabilities for Inclusive Practice (Department of Health , 2007) report: working in partnership, respecting diversity.

Assessment requires service users’ participation and access to information to make informed choice. This model of assessment has to be cultural sensitive and proactive in nature.

Psychosocial assessment

Although social support is frequently referred to as beneficial in relation to depression, there has been little attempt to specify what this means and to evaluate the effectiveness of interventions to reduce isolation.

(Tew, 2004) Partnership working is crucial in adopting a social model of intervention. Culturally sensitive practice.

(Gater, Waheed, Husain, Tomenson, Aseem, & Creed, 2010)

(Webber W. , 2011)

Research indicates that (Oakley, Strange, Toroyan, Wiggins, Roberts, & Stephenson, 2003)

Mental health is practice within a context of multi-disciplinary collaboration to integrate the bio-psychosocial model of practice. The implementation of EBP within this context has to account for the theoretical assumptions that underpin this area of practice. This involves training and supervision. Research by (Huxley, et al., 2005) indicated stress of workers as accounting for their lack of implementing EBP.

— noted that another reason for EBP not been implemented is due to stereotypical assumptions that black and ethnic minorities prefer informal support than support from professional.

One barrier to effective assessment and intervention for depression epidemiology

Another barrier is the reluctance of ethnic minority group to share their emotional symptoms due to family pressure and perceive stigma. To overcome these barriers, —social intervention that accounts for social capital is crucial.

EBP therefore requires practice that is needs not resources leads if services are to be provided that are of sound professional judgement.

Perceptions about depression and stigma have been empirically supported in experimental, cross-sectional and longitudinal studies to worsen depression and affect interpersonal outcome and social support (Thomsen, 2006).

Analysis and reflective process of data collection, the transparencies about the relational nature of the research, and the ways which service users perspective are constructed through a respectful partnership and reflexivity of how our values, theoretical assumptions, policies, past experiences and the context in which practice takes place.

Trust and openness in research relationship a reciprocal process

“right- based” analytical approach (Department of Health, 2008) ethical and critical engage that with respectful uncertainties that reflect on the process of engagement and analysis

Mutual and sincere collaboration, over time

“respectful uncertainties”

Using multiple data sources to account for publication biasness and multiple perspectives and ways of knowing

Acknowledgement of complexities of realities

Use of reflexivity – focus on contexts of and relationships between researcher and researched as shaping the creation of knowledge. Ethical consideration in knowledge

(Gask, Aseem, Waquas, & Waheed, 2011) understanding how symptoms are expressed and perceive. Understanding emotional expressiveness within cultural context.

Conclusion

In conclusion, social intervention has highlighted strategies that have demonstrated some success for improving help seeking.

Given the complexities and multi facet dimension of individual experiences and the context in which needs occurs, it is imperative that the uniqueness of individual is taken into account within the paradigm of culturally competent practice (Dalrymple and Burke, 2006). In addition, Social Work practice draws on theoretical knowledge from social sciences, which are usually Eurocentric, it is essential, that Social Work practice integrate knowledge from best evidence for it to meet it ethical obligation to counter oppressive and discriminatory practice (Thompson N. , 2003) (Webber W. , 2011).

(Thompson N. 2003)

“Collaboration is a interprofessional process of communication and decision making that enables shared knowledge and skills in health care providers to synergistically influence the ways service user/patient care and the broader community health services are provided” (Way et al, 2002). The development of collaborative working will necessarily entail close interprofessional working” (Wilson et al., 2008). According to Wilson et al, (2008) and Hughes, Hemmingway & Smith, (2005) interprofessional and collaborative working describes considering the service user in a holistic way, and the benefits to the service user that different organisations, such as Social Workers (SW), Occupational Therapists (OT) and District Nurse (DN) and other health professionals can bring working together can achieve. These definitions describe collaborative working as the act of people working together toward common goals. Integrated working involves putting the service user at the centre of decision making to meet their needs and improve their lives (Dept of Health, 2009).

This paper will focus first see why health care students learn about working together then reviewing government policy and how this can be applied in a Social Care context, then on influencing factors on the outcomes of collaborative working references within the professional literature, and finally, reviewing evidence on collaborative practice in health and social care.

Learning to work collaboratively with other professionals and agencies is a clear expectation of social worker in the ‘prescribed curriculum’ for the new Social Work Degree (DoH 2002). The reasons are plain:

a-? Service users want social workers who can collaborate effectively with others to obtain and

provide services (Audit Commission 2002)

a-? Collaboration is central in implementing strategies for effective care and protection of

children and of vulnerable adultsas underlined, respectively, by the recent report of the

Victoria Climbie Inquiry (Laming 2003) and the earlier ‘No Secrets’ policies (DoH 2000)

a-? Effective collaboration between staff at the ‘front-line’ is also a crucial ingredient in delivering the Government’s broader goals of partnership between services (Whittington 2003).

Experience is growing of what is involved in learning for collaborative practice. This experience promises valuable information for Social Work Degree providers and others developing learning opportunities but has not been systematically researched in UK social work programmes for a decade (Whittington 1992; Whittington et al 1994). The providers of Diploma in Social Work programmes (DipSW) represented an untapped source of directly transferable experience in this area of learning and were therefore chosen as the focus of the study.

Making collaborative practice a reality in institutions requires an understanding of the essential elements, persistent and continuing efforts, and rigorous evaluation of outcomes. Satisfaction, quality, and cost effectiveness are essential factors on two dimensions: outcomes for patient care providers; and outcomes for patients. Ultimately, collaborative practice can be recognized by demonstrated effective communication patterns, achievement of enhanced patient care outcomes, and efficient and effective support services in place. If these criteria are not met, collaborative practice is a myth and not a reality in your institution. Simms LM, Dalston JW, Roberts PW. Collaborative practice: myth or reality? Hosp Health Serv Adm. 1984 Nov-Dec;29(6):36-48. PubMed PMID: 10268659. http://www.ncbi.nlm.nih.gov/pubmed

Health care students are thought about collaboration so that they can see the unique contribution that each professional can bring to the provision of care in a truly holistic way. Learning about working together can help prevent the development of negative stereotypes, which can inhabit interprofessional collaboration. (Tunstall-Pedoe et al 2003) Health care students can link theory they have leant with practice and bring added value of successful collaborative practice. (www.facuity.londondeanery.ac.uk) Learning collaborative practice with other professionals is the core expectation in social work education both qualifying and post grad.

Effective collaboration and interaction can directly influence a SU treatment, in a positive way, and the opposite can be said about ineffective collaboration that can have severe ramifications, which has been cited in numerous public inquiries. Professionals should also share information about SU’s to keep themselves and their colleagues safe from harm.

Working together to safeguard children states that training on safeguarding children and young people should be embedded within a wider framework of commitment to inter and multi-agency working at strategic and operational levels underpinned by shared goals, planning processes and values. The Children Act 1989 recognised that the identification and investigation of child abuse, together with the protection and support of victims and their families, requires multi-agency collaboration. Caring for People (DH, 1989) stated that successful collaboration required a clear, mutual understanding by every agency of each others’ responsibilities and powers, in order to make plain how and with whom collaboration should be secured. It is evident from the above that Government has been actively promoting collaborative working, and this is reflected in professional literature. Hence, the policy climate and legislative backdrop were established to facilitate inter-agency and intra-agency collaboration. The stated aim has been to create high quality, needs-led, co-ordinated services that maximised choice for the service user (Payne, 1995). Political pressure in recent years has focused attention on interprofessional collaboration in SW (Pollard, Sellman & Senior, 2005) and when viewed as a “good thing”, it is worthwhile to critically examine its benefits and drawbacks just what is so good about it. (Leathard, 2003). Interprofessional collaboration benefits the service user by the use of complementary skills, shared knowledge, resources and possibility better job satisfaction. Soon after the new Labour government in 1997 gave a powerful new impetus to the concept of collaboration and partnership between health professionals and services, they recognised this and there was a plethora of social policy initiatives official on collaborative working published. A clear indication of this can be found in NHS Plan (DH, 2000), Modernising the Social Services (DH, 1998a). Policies concentrated on agency structures and better joint working. This was nothing new, since the 1970s there has been a growing emphasis on multiagency working. 1974 saw the first big press involvement in the death of a child (Maria Coldwell) and they questioned why professionals were not able to protect children who they had identified as most at risk. The pendulum of threat to children then swung too much the other way and the thresholds for interventions were significantly lowered, which culminated with the Cleveland Inquiry of 1988 when children were removed from their families when there was little concrete evidence of harm (Butler-Sloss, 1988), with too much emphasis put on the medical opinion. An equilibrium was needed for a collaborative work ethic to share knowledge and skills and Munro (2010) states that other service agencies cannot and should not replace SWs, but there is a requirement for agencies to engage professionally about children, young people and families on their caseloads. The Children Act 2004 (Dept of Health, 2004) and associated government guidance, introduced following the Public Inquiry into the death of Victoria Climbie in 2000, including Every Child Matters (Dept of Health, 2003), were written to stress the importance of interprofessional and multiagency working and to help improve it. The failure to collaborate effectively was highlighted as one of many missed opportunities by the inquiry into the tragic death of Victoria Climbie (Laming, 2003) and Baby Peter (Munro, 2009). There is an assumption that shared information is information understood problems with information sharing and effective commination are cited again and again in public enquiry reports Rose and Barnes 2008; Brandon et al, 2008). These problems can simply be about very practical issues, such as delays in information shearing, lost messages, names and addresses that are incorrectly recorded (Laming 2003 cited in Ten pitfalls and how to avoid them 2010)

An explicit aim was to motivate the contribution of multiagency working. By 1997 Labour had been re elected and rolled out a number of studies into collaboration. These studies revealed the many complexities and obstacles to collaborative working (Weinstein, 2003). The main drivers of the government’s health and social care policies were partnership, collaboration and multi-disciplinary working. One of the areas covered by Working Together to Safeguard Children 2010 (Dept of Health, 2010) stated that organisations and agencies should work together to recognise and manage any individual who presents a risk of harm to children. The Children Act 1989 (Dept of Health, 1989) requires multi-agency collaboration to help indentify and investigate any cases of child abuse, and the protection and support of victims and their families. It should be remembered that everyone brings their piece of expertise/ knowledge to help build the jigsaw (Working Together 2010) and to assess the service user in a holistic way. Although the merits of collaboration have rarely been disputed, the risk of conflict between the professional groups remains.

Some of the barriers to collaboration are different resource allocation systems, different accountability structures, professional tribalism, pace of change and spending constraints

The disadvantages are if commissioning was led by health, an over-emphasis on health care needs, and inequities between patients from different practices

There are challenges in terms of professional and personal resistance to change; it is difficult to change entrenched attitudes even through inter-professional education. Sometimes professionals disagree about the causes of and the solutions to problems, they may have different objectives because of different paradigms (Pierson & M, 2010). There are also several concerns for SWs which include not knowing which assessments to use, appearing to be different or work differently from others in the team, not being taken seriously or listened to by colleagues and not having sufficient time or resources because of budget constraints (Warren, 2007). Some of the reasoning for this pessimistic mood is feelings of inequality and rivalries, the relative status and power of professionals, professional identity and territory. Different patterns of accountability and discretion between professionals, are all contributing factors to these feelings (Hudson, 2002). Thompson (2009) suggests that instead of the SW being viewed as the expert with all the answers to the problems, they should step back and look at what other professionals can contribute. Collaborative working offers a way forward, in which the SW works with everyone involved with the clients; carers, voluntary workers and other professional staff, to maximise the resources, thus giving an opportunity for making progress and affording the service user the best possible care.

Weinstein, et al, (2003) stated that although there are problems with collaborative working, the potential positive outcomes out-weight the negatives. There could be a more integrated, timely and coherent response to the many complex human problems, fewer visits, better record keeping and transfer of information, and some reduction of risk; therefore the whole is greater than the sum of the parts. If SWs work in ‘silos’, working in a vacuum, they are unlikely to maximise their impact (Brodie, 2008). It is important to use collaboration and an interprofessional/multi agency working culture in Social Work in order that the most vulnerable service users receive the best possible assessments of their needs.

The advantages are better understanding of the constraints of each agency and system overall, shared information on local needs, reduction in duplication of assessments, better planning, avoiding the ‘blame culture’ when problems occurred and accessing social care via health less stigmatising. Greater knowledge of the SWs roles and responsibilities by other health care professionals will ensure that the SWs role is not substituted in assessment of the service users circumstances and needs (Munro, 2010). The Munro Report (2010) also states that if everyone holds a piece of the jigsaw a full picture is impossible until every piece is put together.

Working together to Safeguard Children states a multi-professional approach is required to ensure collaboration among all involved, which may include ambulance staff, A&E department staff, coroners’ officers, police, GPs, health visitors, school nurses, community children’s nurses, midwives, paediatricians, palliative or end of life care staff, mental health professionals, substance misuse workers, hospital bereavement staff, voluntary agencies, coroners, pathologists, forensic medical examiners, local authority children’s social care, YOTs, probation, schools, prison staff where a child has died in custody and any others who may find themselves with a contribution to make in individual cases (for example, fire fighters or faith leaders).

In a study by Carpenter et al (2003) concerning the impact on staff of providing integrated care in multi-disciplinary mental health teams in the North of England, the most positive results were found in areas where services were fully integrated.

There is much evidence to suggest that collaboration represents an ethical method of practice where differences are respected, but used creatively to find solutions to complex problems. In essence the service user should be cared for in a holistic approach and to achieve this collaboration is the answer. (1516)

Professor Munro askes “Some local areas have introduced social work-led, multi-agency locality teams to help inform best next steps in respect of a child or young person, including whether a formal child protection intervention is needed. Do you think this is useful? Do you have evidence of it working well? What are the practical implications of this approach?” (http://www.communitycare.co.uk/Articles/2011/01/04/116046/munro-asks-frontline-workers-what-needs-to-change.htm)

The concept of child abuse is historically, socially and culturally bound.

Critically discuss this statement with reference to the subject material and literature.

Introduction

This paper will look at child abuse, what that is in Australia today. Through reviewing literature on child abuse and child protection this paper aims to show that the concept of child abuse is dependent on social and cultural values. In order to discuss child abuse and its relationship to history and social and cultural values it is important to define the term ‘child abuse’ in the child protection field in Australia today. Zuchowski (2009: 30) cites Fernandez as recognizing that the importance of agreed and unambiguous definitions is central to identifying maltreatment and appropriate interventions and that child abuse is a socially constructed concept defined by social, cultural and economic conditions.

In Australian child protection work child abuse is defined in terms of physical, sexual and emotional abuse and in the more contentious area, child neglect. Physical and emotional abuses are defined as acts of commission or omission that cause harm or worse to children. Sexual abuse is defined as the child being used for the sexual gratification of the adult and involves the abuse of trust and power inherent in relationships between adults and children. Neglect is defined as a situation in which the parents/carers fail to provide for the basic essential needs that children require (Tilbury, Osmond, Wilson & Clark 2007:5; Tomison, 2001:48).

The term ‘neglect’ is contentious and implies judgement; Feminism and Post-Modernist theories challenge workers to be critically reflective on the ways in which language contributes to the construction of social values (Healy, 2005:194). Applied to child protection work Feminist, Structuralist and Critical social work theories focus on social and economic resources and recognize the impact that structural disadvantages have on families’ capacities to provide for children (Tilbury et al, 2007:29). Neglect of children was not recognized prior to the industrial revolution and children as young as five were treated as slave labour in orphanages, workhouses and factories, where they were starved, beaten and often kept in leg irons (Tomison, 2001:48). These conditions are illegal in Australia today and would be considered as child abuse by current social values.

History of Child Protection

In the 19th century children were essentially seen as economic units, large families were an investment and children’s’ input was considered essential to family survival (Sanson & Wise, 2001:5).By the turn of the 20th century changes in attitudes to child labour in Australia were reflected in laws such as the Factory Act of New South Wales and Victoria of 1896, compulsory education for all children in all Australian states by 1900 and the establishment of voluntary child rescue groups such as The Victorian Society for the Prevention of Cruelty to Children in 1894 which was concerned with child abuse and the effects of poverty and disadvantage on their living conditions (Sanson & Wise, 2001:5; Tomison, 2001:50).

However, widespread public concern regarding the maltreatment of children only emerged when child abuse was ‘rediscovered’ by Dr H Kempe and his colleagues in the United States in the 1960’s. They coined the term ‘battered baby syndrome’ and their work created interest in child maltreatment around the world. (Tomison , 2001:50; Parton, 2002:5). At the time child abuse was seen as a socio-medical problem, a disease which could be cured and prevented whereas today child abuse is currently framed as a socio-legal problem with the emphasis on gathering and assessing forensic evidence (Parton, 2002:11; Tomison, 2001:52). The professionalization of child protection services during the 1970’s and 1980’s saw the development of risk-assessment tools ; aids to assist workers in making the right decision and to help ensure accountability. These developments saw the worker as the expert; whereas current theories used in social work in Australia such as strengths- based approaches and narrative therapies emphasize a collaborative effort between families and child protection services (Kreuger, 2007:237; Tilbury et al, 2007:16).

The influence of the child rescue movement in the late 19th century on child protection in Australia has been profound, particularly influencing the history of social intervention and removal of Indigenous children from their families (Sanson & Wise, 2001:8.).Child protection in Australia was first provided by predominantly Christian church groups in the non-government sector and targeted abandoned, neglected children and those with families considered ‘socially inadequate’. Initially ‘rescued’ children were boarded with approved families until later years when orphanages were established. In the early days of settlement the deprivation that children suffered in institutions was recognized, leading to foster care or boarding out being the preferred placement for neglected children (Tomison, 2001:49).

Indigenous ‘Child Protection’

From the first white settlement of Australia colonial values and approaches saw the land being regarded as ‘Terra Nullius’, Indigenous people being treated as free labour at best and subsequent laws, policies and practices that forcibly removed Indigenous children from their families (HREOC, 1997:2). The Colonial response to the atrocities perpetrated on the Aboriginal people was to establish a protectorate system which would segregate and therefore supposedly protect Indigenous people. By 1911 most Australian states and territories had reserved land and assigned responsibility and therefore control of Aboriginal people’s lives to a Chief Protector or Protection Board. This power was used to remove Indigenous children from their families with a view to converting them to Christianity (HREOC, 1997). This policy approach would be considered racist by current social standards. Australia has been slow to recognize and respect the cultural values of the Indigenous people of Australia in every way, including child care and protection.

As the population of mixed descent people grew government officials responded by removing children and housing them away from their families with the aim of absorbing and merging them into the non-Indigenous population. The forcible removal of Indigenous children continued in many guises up until the 1960’s; – those people affected by this practice are now known as The Stolen Generation. In New South Wales after 1940, Indigenous and non-Indigenous children came under general child welfare legislation. The inherent racism in policy and practice and lack of recognition of cultural differences ensured that Indigenous families were more readily found to be neglectful. Poverty was equated with neglect and Indigenous families, ineligible for unrestricted welfare support until after 1966, were judged as failing to provide adequately by non-Indigenous standards (HREOC, 1997).

Attachment theory is based on the joint work of John Bowlby and Mary Ainsworth. Attachment theory recognizes the importance of the early relationship between parent and child and its influence on children’s future ability to form healthy relationships. Bowlby’s work on maternal deprivation, based on the premise that attachment to a caregiver is essential for survival, was not applied to Indigenous families in the 1950’s and 60’s in Australia (Bretherton, 1995:759; Osmond & Darlington, 2002:1). This failure can be attributed to the same racist attitudes to Indigenous Australians that saw Australia declared an empty continent by the first settlers (HREOC, 1997). Looking through the lens of attachment theory at Australia’s history of forcible removal of Indigenous children, it is easy to see the legacy of intergenerational suffering and its ongoing impact on the wellbeing of Indigenous communities today (Sanson & Wise, 2001:39). From today’s perspective historic child protection practices imposed on Indigenous Australians are seen as child abuse and maltreatment. Prime Minister Rudd’s apology, in February 2008, for the damage done to Indigenous Australian’s through past policies of removal, evidences the change in Australian social values which are reflected in policy.

In the ‘Bringing them Home Report’ (HREOC, 1997:19), Sir William Deane acknowledges the extent to which present disadvantage flows from past injustices and oppression. The report recognizes the permanent wounding caused to the Stolen Generation by forcible removal and institutional abuse. All states and territories in Australia have accepted the Indigenous Placement Principle as law or policy (SNAIC, 2002:66.)This policy recognizes the importance of retaining Indigenous Australian children’s connections to their community and culture(Ban, 2005:388).

The Indigenous Placement Principle embeds Indigenous cultural values in social policy by seeking to place children within extended families and their communities. This principle is critical to addressing issues such as Indigenous children being six times more likely to be removed than any other Australian children and twenty times more likely to be in the juvenile justice system. This high rate of removal can be attributed to structural issues such as poverty, lack of adequate housing and the intergenerational effects of policies that forcibly and deliberately removed Indigenous children from culture and family (Zuchowski, 2009:76).

In fifty years, approaches to indigenous child protection in Australia have radically changed; they now reflect recognition of past injustices, respect for cultural differences and values and a commitment to partnership and collaboration between governments, services and Indigenous Australians to build capacities and resilience in communities to keep families and children safe (Calma, 2007).

Economic Impacts

Thomson (2003) suggests that there is an institutional blindness to the role that poverty plays in putting children at risk of harm. The rise of economic rationalism as the dominant philosophy through the 1990’s in Australian social policy has been twofold: under- resourcing of welfare services such as child protection and a user -pays approach which sees the poor and needy further disadvantaged. Economic rationalism is a potentially value laden approach where those who are socially and economically disadvantaged held responsible for their circumstances. As Tomison (2001:52) acknowledges the focus of economic rationalism on efficiency, effectiveness and accountability potentially conflicts with the ethical commitments made by social workers such as a commitment to achieving social justice (Tilbury et al 2007:10; AASW, 1999). Economic issues impact the reconciliation process with the Indigenous community as healing and reconciliation relies on redress of past wrongs (HREOC, 1997). Thorpe (2007) also notes that a disproportionate amount of resources in child protection are spent on investigation rather than care.

Current Social Policy Approaches:

Prevention and early intervention

The current discourse on child protection, influenced by strength based and evidence based approaches, ‘has shifted from talking about abuse to talking about harm’ (Zuchowski, 2009:33). Feminism and Post-modernism recognize language as a site which contributes to defining social value; these discourses have also contributed to the shift from talking about abuse to focussing on the harm done to children. ‘Harm’ is defined in The Child Protection Act (1999) as ‘any detrimental effect of a significant nature…on the child’s wellbeing’. This term allows for family and child to contribute to the assessment of what is considered ‘detrimental’ and ‘significant’ (Tilbury et al, 2007:4). The focus since the mid 1990’s in Australia has been on early intervention and prevention (Tomison, 2001:54-55).

“Resilience” has been recognized as a key protective factor in children surviving maltreatment and high risk situations and achieving healthy and adaptive outcomes. The growing recognition that enhancing protective factors to prevent maltreatment of children is cost effective, and provides both social and economic benefits, has seen an increasing focus on the delivery of early intervention and prevention services in Australia. These services are mostly delivered through non-government agencies such as Family Centres in New South Wales. Government policies now focus on ‘health and wellbeing’ through enhancing community, family and individual strengths. These current strengths-based family support approaches are a contrast to historic approaches that sought to place responsibility and blame solely with the parent. Children’s health and wellbeing is now seen as a community responsibility; the impact of the socio-economic environment in which the family lives is now taken into account (Tomison, 2002:7; 2001:55).

Conclusion

According to Tilbury et al “the ‘label’ child abuse changes according to social context and reflects public opinion and values as well as expert opinion” and reflects the degree to which society supports families to care for their children(2007:6). Furthermore understandings of child abuse and neglect ‘differ according to socio-economic status, culture and ethnic background’ (Bowes & Watson, 2004), as cited in Tilbury et al. (2007:6).

What constitutes child abuse is dependent on social and cultural values; this is clearly evidenced in the changes to the treatment and care of children throughout even the short history of Australia since white settlement. The increase in notification and substantiation of children at risk in the last decade is the outcome of a widening definition of what comprises child abuse (Scott, 2006, as cited in Thorpe, 2007:1). Australia’s history of forcible removal of Indigenous children, the disconnection of British migrant children from family, the abuse of children in institutional care and the ongoing social and mental damage that these practices caused is now well known (Thorpe, 2007:1). These historic practices are unacceptable and considered abuse and maltreatment in Australia today. When compared with Australia’s current collaborative and culturally sensitive approach to child protection it is clear that child abuse, and community perception and response to it, reflect the dominant cultural and social values of the day.

1

Catriona Robertson, Student No. 0718540740, Assignment 1, WS3027: Child and Family Welfare, 10th January 2010.

In the words of Thompson we live in a complex society where diversity is the order of the day. This indeed can result into conflict of interest and discrimination. To narrow this down, discrimination borne out of Cultural Diversity in the social care practice is a very pertinent issue in care delivery especially between the service giver and the client alike. This can be explained as the reflection of the differences that comes through their, languages, values, beliefs, thoughts, behavioural action, ideas and reaction.

Basically, is a pointer to the sensitivity nature of the profession and the approaches needed to provide culturally appropriate care that will accommodate and embrace individual’s beliefs, values and culture incorporates individual’s cultural values, beliefs, and practices including sensitive and of course practitioners among others must take cognisance of individual background to facilitate antidiscriminatory practice in service delivery.

When implementing prevention programs to curb any form of discriminatory attitude ,some of the cogent factors that should be considered as sub set of cultural diversity are, ethnicity, socioeconomic status, sexuality, spirituality, and some other areas. Both the internal and external parts of human life can be considered as the understanding of culture. Among diverse of lots of ways to define culture, it can be viewed from the angle of experience, values, knowledge, attitudes, skills, ideas, tastes, and techniques which are transfer from one experienced person in the community to others.

Transmitters of culture are now families both immediate and nuclear, religious group, peer groups social groups, neighbours and professional organisations. Essentially it should be noted that element of culture and diversity are numerous, some cultural experiences could be are biological related factors, like physical stature and colour of skin, whereas others could be sociological related factors, like socioeconomic status and religious connection. Based on these variables it will be wrong and illogical to draw a conclusion regarding people based on the way they appear externally.

It has become imperative for social care practitioners to be very competent cultural, apart from the fact that this could improve the service delivery standard it will help immensely to help in the quest for antidiscriminatory practice in this profession. Some of the importance of this antidiscriminatory practice in this regards is that it will help to facilitate a serene atmosphere whereby social workers will be able to see it as a matter of responsibility to engage in proper conduct, effective ethical services and decision making. This will enable them to be more conscious about the value base of their service users and of course it will help to maintain an ethical standard that could ultimately serve as a platform on which a professional relationship that can facilitate and improve service delivery can be attained in the long run.

Civilization according to Obama can be described as a method of living and an attitude of equal respect for all and sundry. Obama B. (2006).In a similar vein, a speech was delivered by M. Martin in Dublin (2001) in regards to solving the challenges of cultural diversity in the health care Sector in republic of Ireland. Martin stated in his speech that, diversity gives social care practitioners the privilege to develop their knowledge, mental know-how and the understanding of the problems associated with issues cultural diversity in the health care sector from the twin perspectives of both clients and staff. He also identify awareness and sensitivity training workshop for staff as a key requirement for adapting to a diverse population issue. He suggested that such training should be projected towards enhancement of knowledge based development and skills in other to render effective services that are sensitive to cultural diversity.

Diversity according to Thompson, (2001: 34), is a term hugely being used to lay emphasis on the differences between individuals and across groups, and the fact that such differences are best seen as an assets to be valued and affirmed, rather than as problems to be solved. Diversity and difference could result to discrimination and thus oppression can take place.

Moreover, social care workers do encounter many problems and obstacles in attending the elderly, the young and the physically challenged as well. Ireland as a country is fast becoming a much more multi-cultural society where people are coming from diverse cultural and ethnical background obviously people’s ideas thought and expectations based on service delivery will definitely be conflicted , but it is expected that social care practitioners will manage all these issues as a matter of cultural competency. In recent times, it is now not unusual for a practitioner to work with a black or coloured person or a person from an Eastern European country. Nor is it unusual to work with a child from an ethnic minority in residential care.

Another important of antidiscriminatory practice is that it will enable practitioners to have an insight to how human life and experience is characterise by diversity and how is germane to identity formations. Diversity as it may, can be viewed from intersectionality of different dimensions, these factors consist of gender, age, colour, religion, sexual orientation, class differences, culture, sex, physically challenged, immigration status, ethnic background, political ideology and national origin.

Social workers need to understand and placed ultimate premium of the fact that as a rerult of individual differences, somebody somehow might have experience or suffred from exploitation, maginalisation, oppression, poverty, exclusion and stigmatisation. Understandind this fact will not only help a practitioner to manage and deliver good servive but will greatly assist to be able to deal effectively in handling individual’s need individually. According to Worman, (2005) diversity can best be described as, the the disparities that exist between people that ranges from both visible and non-visible. He identifies three different types of diversity: Social diversity which includes age, race, ethnicity and gender, Value diversity such as psychological differences based on personality and attitudes and Informational diversity which includes organisational differences in education, tenure and function. Rather than seeing this as the beginning and end of one the greatest challenges been faced by this profession it should be seen as a means to an end towards achieving a better service delivery.

Perhaps, one of the possible fruits of the challenges of cultural diversity is that it could chrysalises to discrimination talking about the client and the service deliverer . According to Laird, (2008) concerns with racism first emerged in the social-work profession back in the 1970s and during the 1980s major social-work texts appeared to guide practice (Payne, 2005: 277). The new Diploma in Social Work was introduced in 1990 and it made it compulsory for anti-racist practice to be part of the prospectus.

Thompson’s advanced work on the ‘PCS analysis’, (1998, 2006) refers to the personal, cultural and structural levels at which discrimination can occur, as a means of identifying and combating oppression against ethnic service users. As a result of his research Thompson would say that the combination of personal and cultural predispositions can create an ethnocentric outlook. Ethnocentrism results in judging other distinctive groups of people according to the norms of one’s own group. This of course can create more problems rather than solution that ought to be the central major target of the carer and invariably it can lead to frustration on the part of the carer.

Practically, over time it has been proven that problems that arises from discrimination in service delivery if properly addressed and managed will ultimately enhance performance and this to a large extent will help to improve the lives of the clients. Some the discriminatory acts from recent research have their source from language and culture. Ireland for instance is now a cross multicultural country whereby we have huge number of people from Africa and Eastern block. This factor can make or mar service delivery effectiveness depending on how is applied. “Practitioners and service users recognise that language and cultural barriers can limit the provision of effective and meaningful social care.” (Share et al 2009: 423).

Also, antidiscriminatory practice can necessitate the quest for knowledge and information to improve learning. To be effective at their job, Social Care Workers need to acquire the skills in dealing with culturally different co-workers, subordinates peers and clients. Powell (2004) points out those organisations are becoming increasingly aware of the need to understand and respond to demographic trends in the modern employment force. Carer need to gain an awareness and understanding of the environment around them in order to provide effective supports to service users and their individual needs. A lack of knowledge and/or a lack of understanding can lead to discriminatory practice.

Lack of knowledge can simply mean not being aware of the needs and choices of an individual this can lead to complications and frustration on parties. This information may include dietary requirements, religious practices, cultural differences, language barriers or personal rituals.

Thomas (1991), observed that workplace diversity transcend beyond gender and race. It cut across people lifestyle, age, sexual preference, functional speciality and geographical location. Communities and organisations are becoming extremely diverse and are being challenged to manage diversity. Wilson (1997) describes the ‘changing workforce’ as the ‘new workforce’. For example, today’s workforce includes more dual earner families, an older work force, more people of colour and ethnic minorities, more people with disabilities and more homosexual practitioners.

These set of new workers that falls within the groups earlier mentioned are more demanding and their expectation about the employee’s involvement is so great, Provision has to be made for better work and family balance and access to more vital information, legal frameworks should be in force in order to encourage the Irish workforce to acknowledge and appreciate diversity.

The Employment Equality Act 2004 and the Equal Status Act 2000forbid by law on different nine grounds the act of discrimination including race and membership of the travelling community. Section 24 of the Employment Equality Act 2004, states that it is aimed to: ‘Implement the principle of equal treatment between persons irrespective of racial or ethnic origin…..establishing a general framework for equal employment and occupation and equal treatment for men and women in regards to employment, vocational training and promotion.’

As a social care worker, in a diverse workforce, there is a need to recognise and respect such differences. Ethnic and cultural diversity are not a new occurrence in Ireland. The Irish Travelling Community is synonymous with a long history of an indigenous minority group with a strong culture and identity of their own. Only when these differences are acknowledged in a respectable manners and informing ourselves with regard to them can we be rest assured that these differences has been addressed.

Equality and diversity are about the understanding and valuing of difference. It is about creating a working environment that recognises respects and harnesses difference. A fair environment allows everyone to contribute and gives the opportunity to all to fulfil their potential. Practitioners face many challenges in their everyday work environment. In stressful situations it is important to have support, for example, from the team a carer work with, the supervisor or even an individual co-worker.

Consistency is an important tool for any practitioner so as to provide the best service for the people that they work with. Powell (2004) explains that ignoring diversity may limit a team in its work to reach a required goal.

According to Powell, practitioners benefit from working in a multicultural environment as it teaches them a culture of inclusion and they can benefit from the range of skills and values that are present in the team. This leads to the absence of discrimination and prejudice and ultimately both the staff and clients benefit from this environment.” “Effective social work education and practice in the increasingly mobile and diverse modern European society requires and understanding of minority ethnic cultures and sensitivity to inter-cultural perspectives.”

The National Association of Social Workers (N.A.S.W) describes the responsibilities of social workers as to ‘act to expand choice and opportunity for all persons, with special regard for vulnerable, disadvantaged, oppressed and exploited people and groups.’ These standards heighten the acceptance and respect for diversity as a fundamental social work value. Share et al (2009) points out that many third level institutions providing social care courses integrate inter-cultural training as part of the prospectus.

Many organisations adopt diversity programmes to combat exclusion in the work place. “Social workers have a professional mandate to identify and challenge organisational systems and individual practices that compromise client service, choice and general well-being.” (Maidment et al, 2002: 399).

Constant rising in Ethnicity and social heterogeneity has been identified as one of the greatest and essential challenges militating against modern societies, and in the same way, one of the most significant opportunities in almost all the advanced countries of the world. One thing that is very certain that can be said about virtually all the modern societies is that is generations are going to be more diverse than ever in a foreseeable future.

According to Putnam (2007). He described in the theoretical tool kit of social science two diametrically opposed perspectives about the effects of diversity on social connections. One of those, he labelled the contact hypotheses which argues that diversity fosters interethnic tolerance and social solidarity.

The more we associate and make more contact with people who are different from us, it will enable us to overcome our initial hesitation and ignorance and come to trust them more. This is true in social care an example been the first time a service user would have had a black worker as a carer there could or would have being name calling because they did not know any better. In some cases this has improved as the client and carer have gotten to know each other and come to realise that the only difference is their culture and not what colour they are.

CONCLUSION

This essay has been able to observe and established that in order for social care work to be effective and fair, social care workers need to acknowledge difference and embrace it so as to reap the benefits of a diverse workforce. Racism has no place for the social care worker in the work place. Working with clients who have diverse needs can only serve to further teach a social care worker and enrich their practice, which in turn promotes their standard of professionalism and experience.

What is recommendable is that there are two sides to a coin, diversity as it may, in totality could be a blessing in disguise because it can propel a society towards achieving or providing the best and the most effective service delivery in the context of social care practice through all the possible learning and training processes that ranges from competency to ethical conducts for all the social care workers.

This essay has shown just what diversity is and what types of diversity challenge social care workers on a daily basis. It has also emphasised how important training and development is in order to give potential social care workers a prepared insight into how diversity can be managed and respected.

The world is a small place and social care workers need to recognise and embrace all cultures and their respective differences in order to further enhance their ability to help all service users in multicultural society. Emphasis has been laid on some the importance of antidiscriminatory practice in the context of this profession like better service delivery, enhancing good relationship, improve professionalism and help to facilitate cultural competence and ethical standard amongst others. All this factors put together will ultimately underpinned the future and best practice for this profession.

The Common Assessment Framework is used by various professionals and agencies to use one process of sharing information and integrate working on a young person (revise & re-word more info) The CAF process is seen as a core element in integrated working and promotes more effective use of time used to assess young people, seen by many as a universal and neutral system used by all agencies. The CAF emerged from the 2003 Green Paper ‘Every Child Matters’ which marked a policy of the integration of practitioners and services. (Wise, C, & Harrison, R, 2005)

Requirements before starting the CAF

As undertaken the role of a youth worker I chose Candi (my 16 year old daughter who lives with her mother from a previous marriage) as the young person I would like to help fill in the CAF form. In the case of the assessment undertaken for the assignment, it was explained to Candi the purpose and outcome of the assessment and she was not being formally assessed, and that the process was to critically evaluate the CAF and set out the module guide and shown to Candi, although unsure at first, Candi was happy to proceed. I choose Candi as the candidate because of the fact of the young people who I practice with are young offenders and because of their court orders, they identities need to be guarded and a majority of the young people flatly refused to take part.

The question is asked of what led to the assessment of the young person which has to clear and an agreed statement by all involved and if any other agencies that are involved with the young person including the young person and families/carers.

Key areas of the CAF is to try and engage the young person with families in the process and try and develop a better understanding of the process and indentify the young person’s ‘needs’ at the earliest perceivable stage, however, with most agencies and services, a majority of families are reluctant and wary of sharing information especially if persons have been involved with any agencies and services in the past. This reluctance is why the young person and family must have the full understanding of the whole process and the benefits so the training of the practitioner must be full and up-to-date (revise) however as a youth worker and assessing the young person, the practitioner has to keep own values and standards apart “if I’m talking to a particular person, it is not a question of trying to lead to my values, but often to try express some different values” (Smith, M, 1994)

Candi has never been involved with any agencies before or assessed officially by any services before, when asked how she would feel about being formally assessed she said she would feel frightened and very nervous of the process and even with her mother present she would be frightened to say the wrong thing in case of herself or parents into trouble.

If there is two or more services involved with the young person, a team would be arranged around the child meeting and then the lead professional would be identified, (reword) however there is a reluctance to become the lead practitioner in the CAF process as that practitioner becomes the bench mark for any further action taken by future agency’s or professionals, the reluctance is out of fear of making mistakes from the pressure of lead practitioner. (revise)

Current family and home situation

While filling this section, Candi felt unsure how to answer the question and looked towards her mother for approval, before giving any personal details about family. This section can difficult for the young person if under 16 and a parent or carer is present, before the assessment is carried out, there are no details of the present family situation whether problems are evident or not, Candi lives as part of a one parent family with her younger sister who is 11 years old and times can difficult with looking after her while her mother works, however some young children come from broken homes with various amount of difficulties or living in children’s home, or with friends which only can build as the young person’s anxiety.

Agency involvement with young person

The assessment process used when carrying out can be very intimidating and very personal, however family or carer support is crucial throughout as personal and private information is obtain, plus information of any agency involvement, doctors, health visitors, connexions and any educational provision and so-forth can to hard to ascertain at the time of the assessment with the young person. Candi found personal details

The process of the CAF tries to consider a Varity of ethical issues with over 30 answers to the question of ethnicity which can be a personal and confusing question to ask to ask a young person. So it is preferred to ask the family or young person to self define their ethnicity and no assumptions should be made by the practitioner. (revise)

Development of the young person

To try and ascertain the development of the young person with worries/needs and strengths/resources a variety of information (revise) involving health, emotional and self esteem with among others which can be difficult to try and collect information about unless if in close contact through personal contact through different circumstances with a more impersonal atmosphere to get to know the young person has a more trusting surrounding. Candi found this section hard to explain, especially about her emotions. Candi did not understand why these questions needed to be asked and their purpose. It was explained emotion needs are important part of a young person’s development and any worries or needs had to be ascertained in order to help the young person and not (revise)

A majority of young people when asked about the Common Assessment framework and what the process was used for would be unsure unless the young person has been explained what the process can be used to try improve areas of life improvement (revise) and improve personal development, however if explained how it may involve a child protection or safeguarding procedures if certain aspects should arise during the assessment process, which could cause concern to the young person, the young person could not be as forth-coming with personal information about family life in general, and especially if the parent or carer is involved in the process. However, the whole process is for the positive aspiration welfare of the young person. (revise)

Parents and carers

Information gathered in the section entitled ‘Parents and carers’ involving information including basic care, emotion warm and boundaries for example can be very personal to the young person and the parent/carer could interfere with any question asked. As with most young people, personal information including emotions can be quite hard to divulge especially if the young person is experiencing life stages including puberty and adolescence. (revise)

Family and environmental

Family and environmental functions including the well-being of the young person plus resources including education but financial consideration can a delicate subject however can give a valuable insight to family matters. Financial difficulty can cause an array of problems which influence social and personal development of the young person either by not enrolling into further education or by ascendance of parents/carers working unsociable and unpractical hours causing family disruption in the family home.(revise) Candi found this part difficult to fill in considering the relationship with ourselves and her mother being there during the assessment. I felt Candi did not answer the questions totally honestly and to her fullest (revise)

Well-being scale

Well-being scale of the child/person by the assessor and the well-being scale 0-10 given by the parent/carer is also used too which can regarded as a redundant tool as a number of different factors can influence the scale however a general indication by the parent/carer on their opinion of the young person’s well-being however it can never give a true reflection (revise)

Improvement and review

Improvement and review which includes the views of the parent/carer/young person (revise)

Young person’s goals

Young person’s personal goals and general view of assessment (revise)

Practitioners goals

Practitioner’s goals and view of assessment (revise)

Conclusions, solutions and actions

Conclusions, solutions and actions is the table or a chance to indentify key areas for change with recommended actions by the whom and estimated time of action which should have all those involved working towards the same agenda and encourage families to what is happening as easier progress is to be made. Specific goals are to be made either short or long term but still be specific in the review time.

The view and thoughts of the young person should be evident throughout the process and capture any comments which are relevant and helpful, “adolescence is therefore seen, as youth workers, as a moment of questioning – a moment in which young people reflect critically in their sense of self, their beliefs and values” (Young, K, 1999 p.28)

The CAF process can help identify needs at an early stage and help education authorities achieve better engagement with young person and with school attendance; future academic aspiration and help the young person improve health and family relationships with siblings and parents/carers.

Noted on bottom of CAF form is a note of exceptional circumstances and significant harm to the young person which asks the question of following safeguard procedures if at any time the practitioner feels that there is an issue. “Those who work with young people have a responsibility to safeguard and promote their welfare” (C. Wise & Harrison. R, 2005 p33), this is an important issue for any practitioner or person who works with a young and is an important responsibility and requires vigilance (reword) and attention to the young person who may not be fulfilling the needs and development potential. (C. Wise & Harrison, R, 2005)

The following are the skills needed in order to work with parents and with the family as a whole: ability to work in partnership with parents; ability to be honest and open even when the information you have to share is unpleasant or painful; ability to communicate with adults; ability to negotiate; ability to provide counselling, warmth, empathy, understanding; ability to tolerate people’s pain and anger; ability to work effectively with groups.

Two skills will be explained further. Starting with the ability to provide empathic understanding, this relies on the ability of the worker to imagine what the service user may be experiencing, relating it to his/hers experience. Empathy also draws on the ability of the worker to be an active listener.

As for the ability to be honest, it is known that some parents are not always honest with social workers, particularly when there are issues of abuse (Department of Health, 1991a; Reder et al; 1993), but it is important for social workers to honest in all dealings with parents. Sometimes this is difficult particularly when sharing difficult decisions with the parents, such as the decision to hold a child protection conference.

The “process” of child protection work is set out in the Working Together guidance (HM Government, 2006a), which is to be followed in conjunction with the Assessment Framework and any local procedures and protocols. Under s47 of the Children Act 1989, local authorities have a duty to make enquiries when there is reason to believe that a child is suffering or is likely to suffer, significant harm

In the case of Bethany where a section 47 enquiry is being considered, a strategy meeting should be held immediately, involving social workers, police, and any other relevant personnel such as referring professionals or when necessary those with medical or legal expertise. Apart from sharing information, the principle focus of the strategy meeting is on planning. This might include coordinating with the enquiry with any criminal investigation, dealing with any immediate issues of safety, deciding what information may be shared with parents and whether any medical examination are required.

When a child’s name is placed on the child protection register, the conference will appoint a lead professional (usually a local authority social worker) and a core group, comprising family members and relevant professionals who have the responsibility for developing and implementing the child protection plan. This plan will be reviewed at further conferences, initially within three months and six months thereafter. Depending on the degree of risk reduction, these subsequent meetings may decide to remove the child’s name from the register. Research on core groups has identified challenges very similar to those facing conferences, especially in ensuring meaningful participation (Harlow and Shardlow, 2006.)

From their study of a hundred and twenty conferences, Farmer and Owen (1995) argued that the dominant focus was on assessing risk, with minimal time devoted to planning and little subsequent reappraisal. They expressed concern that plans often failed to offer therapeutic help to children or to address the needs of parents (including women subjected to domestic violence). More recent research has suggested that, although practical and therapeutic services are generally appreciated by parents, they are often not forthcoming (CSCI, 2006). In this respect, Scourfield and Welsh (2003) argue that child protection work is dominated by a neo-liberal emphasis on monitoring and exhorting parents to change or face losing their children. Despite these difficulties, and re-abuse rates of 25-30%, studies in 1990s found that in roughly two thirds of cases, children’s wellbeing improved while on the child protection register (DH, 1995).

Failures of communication and co-ordination between professionals have been a recurring theme in child maltreatment “scandals”, but eliminating them has proved a daunting challenge.

One major concern has been to strike a balance between spreading responsibility for child protection as widely as possible while ensuring there are clear lines of accountability. For example, there have been moves to make child protection “everyone’s business” (Scottish Executive,2002; HM Government,2006b). In England and Wales, s11 of theChildren Act 2004 and s175 of the Education Act 2002 created a general duty for a range of public bodies to safeguard and promote the welfare of children. Working Together (HM Government, 2006a: 39-73) sets out various requirements for organisations to nominate key professionals to co-ordinate child protection work at their particular level (Murphy,2004), while the Children Act 2004, s12, creates a duty on professionals to notify any cause for concern to the information-sharing index. Training, especially on an inter-professional basis, has also been recognised as crucial to facilitating communication and co-ordination (Glennie,2007).

Yet, despite the many positive developments in relation to co-ordination, the challenges remain significant (Murphy,2004). Different professional roles and training generate particular “ways of seeing” in respect of assessment and these are likely to be reinforced by agency cultures (Birchall and Hallett,1995). In practice, this often means different thresholds for assessing significant harm and consequent tensions when these views are not shared by others (Stanley et al;2003). Duties to co-operate have co-existed with increasing pressures on individual professionals and agencies and unsurprisingly, it has often proved difficult to engage those for whom child protection is not regarded as part of their “core business” (Francis et al; 2006). Responsibilities have thus tended to remain with social workers, with some evidence that other professionals may seek to avoid involvement in child protection work (Harlow and Shardlow, 2006). Inter-professional relationships are also affected by issues of power and status and may be based on generalised or even stereotypical views of others.

In relation to communication, there are two related challenges to be faced. The first is that confidentiality, which has both interpersonal and professional dimensions. Thus, individual practitioners must address issues of confidentiality in light of their relationship with service users, but professional cultures and agency rules will also shape what information must (not) be kept confidential. A second, broader challenge is to decide from the massive volume of information gleaned which items are to be exchanged, with whom, and in what form, something that ultimately relies on professional judgement but is also influenced by inter personal processes (Reder and Duncan, 2003). Finally, it should be recognised that all the above challenges can be exacerbated by staff turnover and by agency reorganisations.

Reflecting the growing concern not only that resources were directed more to child protection services than to preventive and support services but also that there were weaknesses at strategic and operational levels about how professionals jointly supported children and their families, the government established requirements for inter-agency collaboration in the 2004 Children Act. Under sections 10 and 11 of this Act, the Director of Children’s Services is accountable for collaborative partnerships across agencies involved with the wellbeing of children to assist professionals to coordinate services focused on prevention and early intervention and, where appropriate, to plan and develop joint services.

In March 2007, the government published a review of family policy resulting from an extensive consultation with providers of services, young people and parents to lay the foundation for government spending over a three-year cycle from 2008 (HM Treasury and DFES, 2007). As part of the Every Child Matters agenda, the government is aiming to address the imbalance in the allocation of resources between prevention services and protection services and also to develop a more effective multidisciplinary framework of professional skills to enhance the effectiveness of prevention services.

Two broad aims are to develop the resilience of children to adverse factors in their family and social circumstances and also to address the needs of families “caught in a cycle of low attainment”. The goal is to increase the provision of “preventive” services but where necessary to require resistant families to use the services by setting consequences for parents through forms of Anti-Social Behaviour Orders and Parenting Orders. The intention is to enable local authorities to use additional funding flexibly to develop services provided either directly by the local authority or through multidisciplinary settings such as “extended school” services or children’s centres for younger children. The policy review commissioned four areas of “sub-review”: developing preventive approaches, children and families at risk through “low attainment”; needs of disabled children; needs of young people.

These policy aims will inform not only funding streams to local authorities, child health and education but also expectations about workforce skills developments (www.hm-treasury.gov.uk)

Families say that they value the social worker who helps them find their solutions to family problems. This approach takes into account service users’ anxieties about sharing family information with professionals and harnesses the family’s strengths to build self-confidence and more sustained solutions. The whole family approach, family focused and child centred is central to working with children and their families in a multi-agency setting. Social workers bring a broad knowledge and skills base and are able to move beyond functions into solutions. They need to influence those other agencies surrounding the child to adopt a more collaborative strength-based approach.

An approach that respects the family but does not condone the behaviour towards the child or the child’s behaviour is likely to enable the family to respond to early intervention and to take up services offered rather than being driven to use the services by compulsion. However, social workers cannot at times avoid compulsion, through either a child protection plan or court proceedings. Families need to know what sanctions may follow if there are serious concerns about a child that they do not address. Communication about options and consequences from the outset of intervention is central to good practice. Such clear communication is also needed for other agencies that may be involved. Families and children should not need to repeatedly share with professionals from different settings the difficulties they are experiencing.

A key skill social workers bring to their practice is the capacity to understand the issues from the family’s standpoint. Social workers need to take into account the impact of poverty, social marginalisation, discrimination and poor health on parenting capacity and children’s development. Social workers are the bridge to enabling other professionals to acknowledge the need for services and their responsibility to provide suitable services.

Clear communication is a prerequisite to establishing good partnerships with children, the family and the professionals involved. Work needs to be planned around time to listen, time to reflect and time to establish relationships with the child and the parents at a pace that works for them.

Communication means not only using language that families understand, so that terms familiar to professionals are properly explained and examples given, it also means establishing in what way they wish to share information. This principle needs to be embedded in the practice of all the professionals delivering services to the families. Some families may wish to use an appropriately skilled interpreter. Some may want to share with the social worker the task of making written records or completing assessment forms. Other families may feel unable to say that written records disenfranchise them because of limited literacy skills.

Services plans should be transparent and should clearly set out which agencies are involved, what is being provided, for how long and what are the consequences of not using the services. Plans need to be reviewed regularly and families need to know who has responsibility in multi-agency plans to deal with disagreement, to account for lapses in service provision and to ensure that reviews are held.

For families the government’s proposals under the Every Child Matters agenda create the possibility of improvements in accessing services across agencies. However, joint planning and commissioning will only be effective if parents, families and children are consulted about what services are useful to them. Services delivered through extended schools and children’s centres need to be innovative and harness the skills of the third sector to deliver not only universal services but also services for children with additional and specialist needs.

Social workers and their managers are well placed to drive forward more effective ways of working directly with families: the risk is that processes designed to ensure accountability will create unnecessary barriers for skilled professionals who want to work alongside families to support them to find solutions.

in 2000, the New Labour government published the Framework for the Assessment of Children in Need and Their Families (DH et al; 2000). The Framework was to be applied to all assessments under the Children Act 1989, whether for children in need (s17) or where “significant harm” was suspected (s47). The Assessment Framework (DH et al; 2000:10-16) sets out the following key principles: Assessments should be child centred, rooted in child development; ecological in their approach; ensure equality of opportunity; involve working with children and families; build on strengths as well as identify difficulties; are inter-agency in their approach to assessment and the provision of services; are a continuing process, not a single event; are carried out in parallel with other action and providing services; are grounded in evidence-based knowledge.

Any assessment of a child and his family which aims to understand what is happening to a child has to take account of a child’s developmental needs, the parenting capacity to respond to those needs, and the wider family and environmental factors. Together these form three systems whose interactions have direct impact on the current and long term wellbeing of a child. The Assessment Framework represents a way of trying to capture the complexity of a child’s world and beginning to construct a coherent approach to collecting and analysing information about each child.

The Framework should be rooted in understandings of child development. Contemporary thinking about children’s needs has evolved over several decades and reflects a mixture of theoretical influences and evidence derived from research studies.Taylor (2004) identifies the following needs: basic physical care, affection, security, stimulation, guidance, control and discipline, responsibility, independence. As assessment has become increasingly rationalised, it has become more common to adopt a “balance sheet” approach, often couched in terms of risk factors i.e. the increased probability of a particular (negative) outcome and protective factors that decrease its likelihood.

An important factor behind the increasing interest in parenting has been a focus on the impact of mental health problems, substance misuse and domestic violence on parents and, in turn, children. Research in the 1990s suggested that these played an important role in many child welfare cases, especially when present in combination, but that they were neither well understood nor addressed in practice (Cleaver et al; 1999). They are relevant in two main ways. First, background knowledge of the impact is an important factor in decision making and second, there may be particular implications for the process of assessment and how it is managed. While each of these areas has distinctive characteristics, there are also common treads. One is that assessment demands a careful balancing act to avoid over or under reaction.Thus, despite heightened risk to children’s welfare, it is important to recognise that those suffering from mental health and other problems do not necessarily make poor parents, and that the majority of their children grow up without major ill-effects (Cleaver, 2002).

An adult who violently assaults another adult in the home is, in fact, also abusing children who may see, hear or be aware of that violence. Hughes, 1992, found that in 90 per cent of cases of domestic violence, children were in the same or the next room. This “indirect abuse”, is a form of emotional abuse, and actually one of the more severe forms. (Bearing in mind that emotional abuse and neglect are closely related, we might also see it as neglect of the child’s needs.) Children are exposed to feelings of terror, grief, impotence, and to the realisation that adults on whom they may rely for safety, security and protection are either, incapable of protecting even themselves, or, capable of dangerous violence towards those they are supposed to protect (Kelly, 1994:44). Since the implementation of the Adoption and Children Act in December 2005, the Children Act 1989 definition of significant harm has expressly included “impairment suffered from seeing or hearing the ill-treatment of another”.

A crucial element of the Framework was to emphasise the interconnectedness of the three domains, drawing on the ecological theory of Bronfenbrenner (1979). In essence, Bronfenbrenner construes the factors influencing the child’s development as a series of four concentric circles, which he refers to as systems ranging from the child’s immediate environment to the broadest social context. The microsystem describes any setting where the child is an active participant, typically the family, school, peer group or immediate neighbourhood. The mesosystem comprises relationships between microsystems, for example between home and school. Finally, the macrosystem comprises the broader social environment in which children and families live, including cultural values, customs, economy and laws.

Arguably the most influential theoretical framework within assessment and child social care more broadly is that based on attachment. Originally derived from the work of Bowlby (1953), attachment theory emphasises the importance of relationships between children and parental figures, especially mothers. Bowlby was particularly concerned with the negative consequences of lost or poor attachment which led to “maternal deprivation”. Subsequently, his work attracted criticism for its gendered assumptions and ethnocentricity, but having fallen out of fashion, attachment theory was “rediscovered” during the 1990s (Thoburn, 1999) and its importance was made explicit in the Assessment Framework.

Fahlberg (1994) has defined attachment as “an affectionate bond between two individuals that endures through space and time and serves to join them emotionally”. She argues that the development of attachment occurs through a cycle of “arousal and relaxation”, wherein the child becomes aroused through needs such as food or comfort, but relaxes once these needs are met by the attachment figure. Repetition of the cycle develops trust and a sense of security for the child. Fahlberg also points to a positive interaction cycle, where play and humour make interaction enjoyable and mutually rewarding and attachment is strengthened. The longer-term importance of attachment is that it should provide children with a “secure base” from which to explore the social world and give them an “internal working model” for relationships based on trust. Although open to change through later experiences, these models exert a strong and often enduring influence over the lives of children and adults (Howe,2001).

Needless to say, such processes do not always follow this path and, while a complete absence of attachment is rare, insecure attachment may affect up to half of the population (Howe,2001). Building on Ainsworth et al’s (1978) work, insecure attachments are customarily divided into three categories: anxious avoidant (detached), anxious resistant (ambivalent) and disorganised/controlling. Each is associated with specific attachment behaviours, such as the reaction to separation, and wider patterns of behaviour.

Howe (2003) argues that attachment behaviours reflect how children “make sense of adults” both emotionally and cognitively and are typically adaptive responses to their care environment. Within assessment, therefore, attachment behaviours can give important insights into children’s well-being and development, while the theory may help to explain the factors that lie behind them and to gauge the potential for change. Understanding attachment is particularly pertinent when temporary or permanent removal of a child is being considered, both in terms of recognising the effects of removal and the importance of maintaining contact between children and birth family members including siblings (Sanders,2004). Information on attachment can be gleaned from interviews, direct work with children, from other professionals and perhaps most importantly observation, but as Howe (2003) warns, assessing attachments is a complex task that requires experience and cautious handling.

Explanatory accounts of child maltreatment have emanated from all the major schools of psychology. Their primary focus rests with individual perpetrators, but to a greater or lesser extent they also address ideas of “intergenerational transmission”, examining the ways in which the childhood victims of maltreatment may become perpetrators as adults. Although they enjoy little support, there are also “pre-psychological” theories rooted in biology and ideas of instinct (Corby, 2005:156-158).

Psychodynamic perspectives (broadly derived from Freudian psychology) emphasise developmental stages and the formation of personality as these stages are negotiated (Mc Cluskey and Hooper, 2000). In relation to child maltreatment, attention has focused on how a parent’s own childhood may influence their capacity to recognise and meet children’s needs, whether they have acquired a rigid personality, become easily frustrated or have difficulty in controlling aggression. This is evident in the case of Bethany where behaviour appears at first sight to be neglectful or abusive but seems in fact to be the result of genuine ignorance about the needs of a child or the role of a parent. Some adults may have lacked appropriate role models while growing up; some are very isolated and have little access to sources of advice. When there seems to be a lack of knowledge or of parenting skills, an appropriate form of intervention is education: the provision of advice, information, instruction or role models.

Social learning theory focuses on how behaviour is learned through processes of observation, conditioning and reinforcement. In line with the theory, intervention would focus on identifying these patterns and seeking to modify them through behavioural therapy, perhaps by working on avoiding “triggers” for maltreatment or reinforcing appropriate parental responses. Throughout her childhood, Bethany witnessed violence hence repeating the same behaviour as an adult.

A basic feature of anti discriminatory practice is the ability to see that discrimination and oppression are so often central to the situations social workers encounter. The fact that social work service users are predominantly from disadvantaged groups is unlikely to be seen as a key issue. However, what anti discriminatory practice teaches us is that discrimination and oppression are vitally important matters and, if we are not attuned to recognising and challenging discrimination, we run the risk of, at best condoning it and, at worst exacerbating and amplifying it through our own action.

Overarching both the 1989 and the 2004 Children Act is the 1998 Human Rights Act which requires agencies with responsibilities for child health, education and welfare services to comply with the requirements of the European Convention on Human Rights. Of particular relevance is Article 8, respect for private and family life. This Article does not give an absolute guarantee to family life and therefore to services to support a family to bring up their children. It is a “qualified” right, and the State and its agencies have to balance the child’s entitlement to grow up cared for by their family, who may need support services to do so, against the duty to protect the child and, where necessary following a fair and transparent process, to remove the child from the family.

The duty on the Director of the Children’s Services to plan with other agencies to commission and provide support services to promote children’s wellbeing must comply with both international obligation and domestic law to ensure that service provision is non-discriminatory

Abuse is a word that has several connotations associated with it. There is a multitude of ways abuse can be carried out, and its consequences or effects can range in an unlimited number of possibilities. Abusive cases regarding anybody should be taken very seriously and with compassion (when it comes to the victim). However, the abuse of a child, especially in a sexual way, is the most dangerous and horrendous form of abuse and can lead to a cycle of abuse later on. Children are typically defenseless and because they are so young and still developing, it is harder for them to understand what is going on and how to deal with it. In some cases, a child who has been sexually abused will absorb some of these characteristics and even abuse others as they get older because it is how they grew up and all they know.

Child sexual abuse is extremely detrimental as it can cause long-term issues for life. For this reason, the group decided to cover the topic of preventing child abuse because prevention is the best cure. Prevention of child abuse has to be the number one step that society takes, so that an innocent life will not be unnecessarily disturbed or in the worst cases, ruined. In my section of child sexual abuse, I define prevention in more than a sentence because there are many techniques for preventing child abuse and there are a number of circumstances where prevention can be applied. Our presentation by topic follows in this order: Types of Abuse, Preconditions for Child Sexual Abuse, Children at Risk, Effects of Child Abuse, Sexual Abuse Trauma, Treatment Programs, and lastly Preventing Sexual Abuse.

The first point of my presentation includes defining what prevention is and means in the context of child sexual abuse. When we think about the word prevent, it seems pretty simple: stop something from happening. Preventing child sexual abuse is not always this simple though. Those that abuse children sexually have a disorder and have something seriously wrong with their mental processes. Even if a person has been treated for abusive behavior and appear to be normal, there is always a chance of relapse just like with former drug users. That desire to do what they like to do never fully disappears, no matter how well they have rehabilitated, and this is an unavoidable obstacle for recovery even after prevention.

The very best way for preventing child sexual abuse and a future child sexual abuser is by the practice of good parenting or guardianship. Children with responsible and loving guardians are less likely to be abused because their guardians are cautious and protective of them. A child with these circumstances are also vastly less likely to abuse as they get older because they are brought up in a proper environment with good role models to follow.

It is a common misconception a child is more likely to be sexually abused by a stranger rather than by a family member or someone trusted by the family. In reality, 30-40% of reported child sexual abuse concerns a family member, and about 50% of sexually abused children are molested by a person the family knows (darkness2light.org). This means that only 10% of children who have been sexually abused are abused by strangers, so it is critical that prevention starts in the home. Another thing to think about is that these statistics only involve reported cases. A child is more likely to reveal information about abuse committed by a stranger than by a parent, relative, or family friend. With that said, the likelihood is probably even higher that a child will be sexually abused by someone they know rather than by a complete stranger.

Another reason why it is so important that prevention of child abuse starts in the home by the guardians is because 70% of reported sexual assaults are carried out on individuals seventeen and younger (darkness2light.org). The reason for this of course is that kids under this age are vulnerable and less aware of the dangers people may pose. They also have a harder time understanding why something like this could be happening to them.

For all children to have responsible and protective guardians would be to live in a perfect world and this is unfortunately impossible. Sometimes a good environment at home is unrealistic, and extra preventative measures must be taken to stop or at least correct a sexually abusive situation. Society as a whole must come together to create an environment outside of the childrenaˆ™s nuclear home. If a child is being sexually abused in their home and then come out to an environment with no helpful recourses or information available to them, they stand no chance. That is why it is crucial for places such as schools, hospitals, religious places, or wherever else it may be, to educate children on what is right and wrong as far as how they should be treated. As hard as it may be to understand, children who are abused by their parents or close ones will usually still love them and feel deeply attached, so they will be scared or hesitant to report abuse in fear of disappointment, worse treatment, or even abandonment (childabuse.gov). By educating children on the subject and by making them understand that it is not their fault, it is possible to create a place where the child feel comfortable enough to be honest and forward.

On top of the places mentioned previously, there are also numerous recourses available specifically designed for preventing and educating when it comes to child sexual abuse. Programs like NCTSN (National Child Traumatic Stress Network) can educate parents on how to prevent their child from being abused and what signs to look for if they have been. Websites such as darkness2light.org has a list of national and local programs that deal with everything from prevention to rehabilitation. By typing in aˆ?Child Sexual Abuse Preventionaˆ? in google one can clearly see that there is no lack of resources out there. There are thousands of programs designed to specifically prevent sexual abuse of a child, and even help restore the lives of those that have been taken away from abuse. There is even a national hotline, 1-800-4-A-CHILD, with operators and counselors committed to helping these victims.

From my project research and experience, I became more knowledgeable in the ways sexual abuse of a child can be prevented, and how individuals as well as society as a whole can help children who are already being abused. Sexual abuse, especially on a child, is in my opinion one of the worst and immoral things you can do as a human being. I learned that the people who commit this type of abuse to this demographic are often deranged and have no control over their compulsive desire to commit these atrocities. The very best thing we can do to prevent this type of destruction to a childaˆ™s life is to start with care and preventative measures inside the home and to implicate these measures outside the homes in public places as well. More than anything, I learned that prevention of this is not a simple task. It is almost impossible to protect a child inside their own home with abusive parents, if there is no evidence and the child is silent about the situation. We must all work together to put the knowledge out there for children on when they should go for help.